Provider Demographics
NPI:1407720899
Name:ROY PEDIATRIC DENTISTRY LLC DBA WEE CARE PEDIATRIC DENTISTRY AND ORTHODONTICS
Entity type:Organization
Organization Name:ROY PEDIATRIC DENTISTRY LLC DBA WEE CARE PEDIATRIC DENTISTRY AND ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ODION
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-254-9700
Mailing Address - Street 1:5682 S 3500 W UNIT A
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9108
Mailing Address - Country:US
Mailing Address - Phone:801-773-8644
Mailing Address - Fax:801-773-9828
Practice Address - Street 1:5682 S 3500 W UNIT A
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9108
Practice Address - Country:US
Practice Address - Phone:801-773-8644
Practice Address - Fax:801-773-9828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty