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Organization

LEGACY PEDIATRIC DENTISTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SCOTT C FOLKMAN D.M.D. (OWNER/PRINCIPAL)
(801) 710-4593
Entity
Organization

Contact information

Practice address
3225 W GORDON AVE, STE G, LAYTON, UT 84041-6508
(801) 544-3400
(801) 544-3402
Mailing address
3225 W GORDON AVE, STE G, LAYTON, UT 84041-6508
(801) 544-3400
(801) 544-3402

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8224117-9923
UT

Other

Enumeration date
04/07/2012
Last updated
04/07/2012
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