| Abc Pediatric Dentistry, Pc | |
|
65 N Gateway Dr Ste 1 Providence UT 84332-6102 | |
| (435) 787-2223 | |
| (435) 752-9296 |
| Full Name | Abc Pediatric Dentistry, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 65 N Gateway Dr Ste 1, Providence, Utah |
| Authorized Official Name and Position | Stanton C. Allen (OWNER) |
| Authorized Official Contact | 4357872223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc Pediatric Dentistry, Pc 65 N Gateway Dr Ste 1 Providence UT 84332-6102 Ph: (435) 787-2223 | Abc Pediatric Dentistry, Pc 65 N Gateway Dr Ste 1 Providence UT 84332-6102 Ph: (435) 787-2223 |
| NPI Number | 1992119390 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 02/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992119390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 5854224 (Utah) | Primary |
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