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Contact Information

HERITAGE PARK BOULEVARD DENTAL PLLC
2719 US-89
SUITE 100
OGDEN, UT84404
 Phone: 801-782-5792
 Fax: 801-782-3339
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for HERITAGE PARK BOULEVARD DENTAL PLLC

NPI # 1417739715
LBN Legal business name HERITAGE PARK BOULEVARD DENTAL PLLC
Authorized official JENNY GARCIA-ROCHA - (SR TEAM LEAD)
Entity Organization
Organization subpart 1 No
Enumeration date 10/20/2023
Last updated 10/20/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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