Organization
HIDDEN VALLEY PEDIATRIC DENTAL INC
Active
Other names
Adventure Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT CARL DEHART D.D.S. (OWNER)
(801) 495-1610
Entity
Organization
Contact information
Practice address
114 E 12450 S STE 200, DRAPER, UT 84020-8060
(801) 495-1610
(801) 495-1631
Mailing address
114 E 12450 S STE 200, DRAPER, UT 84020-8060
(801) 495-1610
(801) 495-1631
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2008
Last updated
02/13/2008
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