Organization
UT SPECIALTY DENTAL SERVICES, PLLC
Active
Parent organization
UT SPECIALTY DENTAL SERVICES, PLLC
Other names
Pediatric Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
UT SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE V DASCH (DIRECTOR OF CRED AND PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
497 N MAIN ST, SPANISH FORK, UT 84660-3002
(801) 798-2100
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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