Organization Name: | CHILDREN'S CORNER PEDIATRIC DENTISTRY |
NPI Number: | 1023320728 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STUART D SEGURA (PARTNER) |
Mailing Address: | 275 W 200 N Ste 175 Lindon |
State: | UT US |
Postal Code: | 840425009 |
Phone Number: | 8017692530 |
Fax Number: | 8017692531 |
NPI Enumeration Date: | 07/09/2010 |
NPI Last Update Date: | 07/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 7108173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |