Organization
SOUTH DAVIS PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ODION DDS (OWNER)
(801) 294-8880
Entity
Organization
Contact information
Practice address
59 W PAGES LN STE 110, BOUNTIFUL, UT 84010-5988
(801) 294-8880
Mailing address
59 W PAGES LN STE 110, BOUNTIFUL, UT 84010-5988
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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