Organization
PEDIATRIC DENTAL CARE
Active
Other names
Bret J Sorensen
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRET J SORENSEN DDS (OWNER)
(801) 798-2100
Entity
Organization
Contact information
Practice address
497 N MAIN ST, SPANISH FORK, UT 84660-3002
(801) 798-2100
(801) 798-9977
Mailing address
497 N MAIN ST, SPANISH FORK, UT 84660-3002
(801) 798-2100
(801) 798-9977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
363178-9923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528178604002
—
UT
05
—
529511826002
—
UT
Enumeration date
09/08/2016
Last updated
09/08/2016
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