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Organization

ROMNEY PEDIATRIC DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. L. CLARK ROMNEY DMD (DENTIST)
(307) 362-3125
Entity
Organization

Contact information

Practice address
525 E 100 S STE 430, SLC, UT 84102-2074
(801) 532-1402
(801) 328-3054
Mailing address
525 E 100 S STE 430, SALT LAKE CITY, UT 84102-2074
(307) 362-3125
(801) 328-3054

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598924078
INDIVIDUAL NPI
Enumeration date
01/12/2012
Last updated
04/17/2012
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