Organization
LELAND W. PACK D.M.D., M.S. ORTHODONTICS & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LELAND WILLIAM PACK D.M.D.,M.S. (PRESIDENT)
(801) 621-5892
Entity
Organization
Contact information
Practice address
1067 24TH ST, OGDEN, UT 84401-2758
(801) 621-5892
Mailing address
1067 24TH ST, OGDEN, UT 84401-2758
(801) 621-5892
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
324142-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528376102006
—
UT
Enumeration date
03/21/2007
Last updated
09/13/2016
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