Cache Valley Dental Associates LLC

NPI #1295398352 in Logan, Utah

Provider Information

NPI Number: 1295398352
Entity Type: Organization
Organization Name: Cache Valley Dental Associates LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 15, 2019
Last Updated: Apr 15, 2019

Practice Location

Address: 120 W CACHE VALLEY BLVD STE 200
City: Logan
State: Utah
ZIP Code: 84341-2697
Phone: (435) 753-7563

Authorized Official

Name: ANTHONY LARSON, DDS
Title: OWNER/REGISTERED AGENT
Phone: (435) 232-1232

Specialties & Taxonomy Codes

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

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