Provo Orem Family & Cosmetic Dentistry Pllc

NPI #1538554878 in Provo, Utah

Provider Information

NPI Number: 1538554878
Entity Type: Organization
Organization Name: Provo Orem Family & Cosmetic Dentistry Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 3, 2015
Last Updated: Apr 3, 2015

Practice Location

Address: 2255 N UNIVERSITY PKWY
Address 2: SUITE 39
City: Provo
State: Utah
ZIP Code: 84604-1588
Phone: (706) 207-1102

Authorized Official

Name: DR. JASON MICHAEL CAMPBELL, D.D.S
Title: PRESIDENT
Phone: (706) 207-1102

Specialties & Taxonomy Codes

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

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