Organization
PITT FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON PITT DDS (PRESIDENT)
(801) 295-6192
Entity
Organization
Contact information
Practice address
281 SOUTH MAIN, CENTERVILLE, UT 84014
(801) 295-6192
(801) 295-6011
Mailing address
PO BOX 428, 281 SOUTH MAIN, CENTERVILLE, UT 84014
(801) 295-6192
(801) 295-6011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
134487
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529566754005
—
UT
Enumeration date
02/26/2007
Last updated
08/22/2020
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