Organization
KIDS TOWN PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT PACKHAM DDS (OWNER/DENTIST)
(801) 799-2900
Entity
Organization
Contact information
Practice address
2940 N. CHURCH ST., #301, LAYTON, UT 84040
(801) 799-2900
(801) 217-3950
Mailing address
2940 N. CHURCH ST., #301, LAYTON, UT 84040
(801) 799-2900
(801) 217-3950
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6362621-9922
UT
Other
Enumeration date
04/03/2012
Last updated
07/17/2013
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