| Organization Name: | DENTISTRY FOR CHILDREN WEST VALLEY PC |
| NPI Number: | 1922308618 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY L DAVILA (OFFICE MANAGER) |
| Mailing Address: | 3540 S 4000 W Ste 440 West Valley |
| State: | UT US |
| Postal Code: | 841203295 |
| Phone Number: | 8019555200 |
| Fax Number: | 8019551707 |
| NPI Enumeration Date: | 10/27/2010 |
| NPI Last Update Date: | 10/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 5247754 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |