Intermountain Dental Associates-Endodontics

NPI #1881962785 in North Ogden, Utah

Provider Information

NPI Number
1881962785
Entity Type
Organization
Organization Name
Intermountain Dental Associates-Endodontics
Subpart
Yes (part of a larger organization)
Parent Organization
INTERMOUNTAIN DENTAL ASSOCIATES SPECIALTY LLC
Primary Specialty
Dentist - Endodontics
Enumeration Date
Dec 6, 2011
Last Updated
Dec 6, 2011

Practice Location

Address
2721 N 400 E
Address 2
SUITE 2
State
Utah
ZIP Code
84414-2393
Phone
(801) 782-5682

Authorized Official

Name
VICKI LEWIS
Title
SPECIALIST COORDINTOR
Phone
(801) 782-5682

Specialties & Taxonomy Codes

Specialty
Dentist - EndodonticsEndodontics

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