Provider Demographics
NPI:1144597691
Name:READING PEDIATRIC DENTISTRY PLLC
Entity Type:Organization
Organization Name:READING PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF PLLC
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:S
Authorized Official - Last Name:READING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-842-9769
Mailing Address - Street 1:3895 W 7800 S
Mailing Address - Street 2:#203
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-4314
Mailing Address - Country:US
Mailing Address - Phone:801-282-6901
Mailing Address - Fax:
Practice Address - Street 1:3895 W 7800 S
Practice Address - Street 2:#203
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4314
Practice Address - Country:US
Practice Address - Phone:801-282-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8119870162261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental