Provider Demographics
NPI:1780421271
Name:WILLDEN FAMILY DENTAL INC
Entity type:Organization
Organization Name:WILLDEN FAMILY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-446-4668
Mailing Address - Street 1:10654 S RIVER HEIGHTS DR STE 330
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5544
Mailing Address - Country:US
Mailing Address - Phone:801-446-4668
Mailing Address - Fax:801-446-6037
Practice Address - Street 1:10654 S RIVER HEIGHTS DR STE 330
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5544
Practice Address - Country:US
Practice Address - Phone:801-446-4668
Practice Address - Fax:801-446-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental