Juan Diaz De Leon, DDS

NPI #1093206112 in Provo, Utah

Provider Information

NPI Number: 1093206112
Entity Type: Individual
Name: Juan Diaz De Leon, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 24, 2018
Last Updated: May 24, 2018

Practice Location

Address: 2520 N UNIVERSITY AVE STE 101
City: Provo
State: Utah
ZIP Code: 84604-6081
Phone: (801) 426-6255

Specialties & Taxonomy Codes

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

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