Organization
STATION PARK PEDIATRIC DENTISTRY
Active
Other names
Boardwalk Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DOLL DMD (BOARD CERTIFIED PEDIATRIC DENTIST)
(480) 278-6749
Entity
Organization
Contact information
Practice address
1195 WEST PARK LN, FARMINGTON, UT 84025
(801) 882-8800
Mailing address
1195 WEST PARK LN, FARMINGTON, UT 84025
(801) 882-8800
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770712838
—
UT
Enumeration date
07/26/2022
Last updated
07/26/2022
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