Organization
YOUNG FAMILY DENTAL WJ
Active
Parent organization
YOUNG FAMILY DENTAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
YOUNG FAMILY DENTAL INC
Authorized official
SUSAN JOHN (PRACTICE ADMIN)
(801) 224-0222
Entity
Organization
Contact information
Practice address
4800 W. 8159 S., WEST JORDAN, UT 84088-8213
(801) 601-8200
(801) 996-3641
Mailing address
4800 W. 8159 S., WEST JORDAN, UT 84088-8213
(801) 601-8200
(801) 996-3641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4766943
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4766943
—
UT
Enumeration date
09/01/2016
Last updated
03/23/2017
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