| White Dome Pediatric Dental Llc | |
|
6025 S. River Rd. Bldg B Ste 3 Saint George UT 84790 | |
| (435) 628-0511 | |
| Not Available |
| Full Name | White Dome Pediatric Dental Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6025 S. River Rd. Bldg B Ste 3, Saint George, Utah |
| Authorized Official Name and Position | Cody Johnson (OWNER) |
| Authorized Official Contact | 4356280511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Dome Pediatric Dental Llc 6025 S. River Rd. Bldg B Ste 3 Saint George UT 84790 Ph: (435) 628-0511 | White Dome Pediatric Dental Llc 6025 S. River Rd. Bldg B Ste 3 Saint George UT 84790 Ph: (435) 628-0511 |
| NPI Number | 1780480665 |
|---|---|
| Provider Enumeration Date | 02/21/2025 |
| Last Update Date | 02/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780480665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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