Clw DDS Pllc

NPI #1871626630 in Eden, Utah

Provider Information

NPI Number: 1871626630
Entity Type: Organization
Organization Name: Clw DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 13, 2007
Last Updated: Nov 6, 2014

Practice Location

Address: 2640 N HIGHWAY 162
City: Eden
State: Utah
ZIP Code: 84310-9745
Phone: (801) 745-1100

Authorized Official

Name: CHAD WAGSTAFF, DDS
Title: PRESIDENT
Phone: (801) 745-1100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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