Organization
SOUTH OGDEN DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROCHELLE RASMUSSEN DDS (OWNER)
(801) 479-3500
Entity
Organization
Contact information
Practice address
5738 S 1475 E STE 200, OGDEN, UT 84403-4859
(801) 479-3500
(801) 479-1600
Mailing address
5738 S 1475 E STE 200, OGDEN, UT 84403-4859
(801) 479-3500
(801) 479-1600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
276306
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52937685101001
—
UT
Enumeration date
12/13/2011
Last updated
12/13/2011
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