Organization
SOUTH HILLS PEDIATRIC DENTAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW JACOBSEN DDS (OWNER)
(801) 589-3150
Entity
Organization
Contact information
Practice address
4013 W 13400 S, RIVERTON, UT 84096-6410
(385) 210-1000
Mailing address
4013 W 13400 S, RIVERTON, UT 84096-6410
(385) 210-1000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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