| Jordan Landing Pediatric Dentistry Dds | |
|
7613 S Jordan Landing Blvd Ste 210 West Jordan UT 84084-1973 | |
| (801) 280-9595 | |
| Not Available |
| Full Name | Jordan Landing Pediatric Dentistry Dds |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7613 S Jordan Landing Blvd Ste 210, West Jordan, Utah |
| Authorized Official Name and Position | Ryan Richard Johansen (DENTIST) |
| Authorized Official Contact | 8012809595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Landing Pediatric Dentistry Dds 7613 S Jordan Landing Blvd Ste 210 West Jordan UT 84084-1973 Ph: (385) 209-5038 | Jordan Landing Pediatric Dentistry Dds 7613 S Jordan Landing Blvd Ste 210 West Jordan UT 84084-1973 Ph: (801) 280-9595 |
| NPI Number | 1265215347 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265215347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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