Clubhouse Pediatric Dentistry Of West Jordan

LBN: Clubhouse Pediatric Dentistry Of West Jordan
Clubhouse Pediatric Dentistry Of West Jordan is an health care organization with primary practice located at 1108 E South Union Ave , Midvale UT 84047-2904. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Clubhouse Pediatric Dentistry Of West Jordan can be contacted via phone (208) 520-1514, or through Robison, Jennifer Louise via phone (208) 520-1514.

Contact Information

Primary practice address
1108 E South Union Ave Midvale UT 84047-2904
Phone: (208) 520-1514
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Robison, Jennifer Louise
Phone: (208) 520-1514

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1639654684
LBN Legal business name Clubhouse Pediatric Dentistry Of West Jordan
DBA Doing business as
Authorized official Robison, Jennifer Louise
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 26th, 2018
Last updated Sep 26th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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