Mountain Valley Dental- Petersen, LLC

NPI #1659582237 in Sandy, Utah

Provider Information

NPI Number: 1659582237
Entity Type: Organization
Organization Name: Mountain Valley Dental- Petersen, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 24, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1025 E 11400 S
Address 2: 102
City: Sandy
State: Utah
ZIP Code: 84094-6942
Phone: (801) 576-8696

Authorized Official

Name: MRS. CORIE ANN SCHULTZ
Title: SENIOR MANAGEMENT
Phone: (801) 573-5572

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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