DR. Niles Walter Herrod, DDS

NPI #1578646642 in Provo, Utah

Provider Information

NPI Number
1578646642
Entity Type
Individual
Name
DR. Niles Walter Herrod, DDS
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Credential
DDS
Enumeration Date
Oct 23, 2006
Last Updated
Jul 9, 2007

Practice Location

Address
777 N 500 W
Address 2
SUITE 102
City
Provo
State
Utah
ZIP Code
84601-1541
Phone
(801) 375-4707

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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