Layton Oral Surgery, P.c. | |
2185 N. 1700 W. #204 Layton UT 84041 | |
(801) 773-9790 | |
Not Available |
Full Name | Layton Oral Surgery, P.c. |
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Speciality | Dentist |
Location | 2185 N. 1700 W., Layton, Utah |
Authorized Official Name and Position | Dayne Jensen (OWNER) |
Authorized Official Contact | 8016987121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Layton Oral Surgery, P.c. 2185 N. 1700 W. #204 Layton UT 84041 Ph: () - | Layton Oral Surgery, P.c. 2185 N. 1700 W. #204 Layton UT 84041 Ph: (801) 773-9790 |
NPI Number | 1770238016 |
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Provider Enumeration Date | 02/15/2022 |
Last Update Date | 02/15/2022 |
Medicare PECOS PAC ID | 0244622538 |
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Medicare Enrollment ID | O20220228001236 |
Identifier | Type | State | Issuer |
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1770238016 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Provider Name | Dennis L Dedecker |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1073516688 PECOS PAC ID: 3678501921 Enrollment ID: I20050729000207 |
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