Adventure Dental
Organization Active NPI Pediatric Dentistry · Draper, UT
NPI 1790793776 · NPPES record last updated Jun 16, 2008
Key facts
- NPI
- 1790793776
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 5832460 (UT)
- Legal business name
- ADVENTURE DENTAL
- Practice address
- 114 E 12450 S
Suite 200
Draper, UT 84020 - Phone
- (801) 495-1610
- Fax
- (801) 495-1631
- NPI assigned
- Aug 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Annie C Huffman
- Title
- Billing Manager
- Phone
- (801) 495-1610
Corporate family (same tax ID) 1
Practitioners 3
-
Brent C Dehart, DDS
-
Ryan C Moffat, DDS
National Provider Directory
- Tax ID family
- Adventure Dental
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry |
1223P0221X | 342300 | UT | |
| Pediatric Dentistry |
1223P0221X | 5832460 | UT | Yes |
Addresses
Primary practice location
114 E 12450 S
Suite 200
Draper, UT 84020
Mailing address
PO Box 830
Draper, UT 84020
Phone (801) 495-1610
Other names
- Hidden Valley Pediatric Dental
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.