Organization
CHILDREN'S DENTAL OF SOUTHERN UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY JACK SCHOLZEN DMD (DOCTOR / OWNER)
(435) 673-7776
Entity
Organization
Contact information
Practice address
2746 E 850 N, ST GEORGE, UT 84790-5839
(435) 673-7776
(435) 627-2592
Mailing address
201 S 700 W, HURRICANE, UT 84737-2423
(435) 673-7776
(435) 627-2592
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6329558-9923
UT
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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