Organization
DENTISTRY FOR CHILDREN SANDY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BUTLER (OFFICE MANAGER)
(801) 562-2222
Entity
Organization
Contact information
Practice address
10011 CENTENNIAL PKWY STE 250, SANDY, UT 84070-4121
(801) 562-2222
(801) 562-2230
Mailing address
10011 CENTENNIAL PKWY STE 250, SANDY, UT 84070-4121
(801) 562-2222
(801) 562-2230
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5247754
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529313580001
—
UT
Enumeration date
11/05/2010
Last updated
11/05/2010
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