| Easy Wisdom Teeth | |
|
2222 W 3500 S A1 West Valley City UT 84119-3464 | |
| (801) 886-3379 | |
| Not Available |
| Full Name | Easy Wisdom Teeth |
|---|---|
| Speciality | Dentist |
| Location | 2222 W 3500 S, West Valley City, Utah |
| Authorized Official Name and Position | Ken John Marz (OWNER) |
| Authorized Official Contact | 8018863379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easy Wisdom Teeth 2222 W 3500 S A1 West Valley City UT 84119-3464 Ph: (801) 886-3379 | Easy Wisdom Teeth 2222 W 3500 S A1 West Valley City UT 84119-3464 Ph: (801) 886-3379 |
| NPI Number | 1568866119 |
|---|---|
| Provider Enumeration Date | 10/10/2014 |
| Last Update Date | 10/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568866119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 275551-9922 (Utah) | Primary |
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