Dhew Ind Hlth Svcs & Mntl Hlth Svcs

NPI #1730341215 in Fort Duchesne, Utah

Provider Information

NPI Number: 1730341215
Entity Type: Organization
Organization Name: Dhew Ind Hlth Svcs & Mntl Hlth Svcs
Primary Specialty: Dentist
Enumeration Date: Jun 26, 2008
Last Updated: Apr 4, 2013

Practice Location

Address: 6822 E 1000 SOUTH
City: Fort Duchesne
State: Utah
ZIP Code: 84026
Phone: (435) 722-5122

Authorized Official

Name: MR. DELBERT GARY MARTIN, RPH
Title: CHIEF PHARMACIST
Phone: (435) 725-6874

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - General Practice — General Practice	1223G0001X
Dentist - Periodontics — Periodontics	1223P0300X
Dental Hygienist	124Q00000X
Dentist	122300000X	Primary

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