Organization
ABC PEDIATRIC DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANTON C. ALLEN DDS. (OWNER)
(435) 787-2223
Entity
Organization
Contact information
Practice address
65 N GATEWAY DR STE 1, PROVIDENCE, UT 84332-6102
(435) 787-2223
(435) 752-9296
Mailing address
65 N GATEWAY DR STE 1, PROVIDENCE, UT 84332-6102
(435) 787-2223
(435) 752-9296
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5854224
UT
Other
Enumeration date
06/13/2014
Last updated
02/19/2018
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