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Organization

JORDAN LANDING PEDIATRIC DENTISTRY DDS

Active
Other names
Jordan Landing Pediatric Dentistry DDS
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN RICHARD JOHANSEN DDS (DENTIST)
(801) 280-9595
Entity
Organization

Contact information

Practice address
7613 S JORDAN LANDING BLVD STE 210, WEST JORDAN, UT 84084-1973
(801) 280-9595
Mailing address
7613 S JORDAN LANDING BLVD STE 210, WEST JORDAN, UT 84084-1973
(385) 209-5038
(801) 280-1169

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
08/14/2023
Last updated
08/14/2023
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