| Lester W Cannon Dds Pc | |
|
1935 E 5600 S Salt Lake City UT 84121-1351 | |
| (801) 277-4049 | |
| (801) 277-9773 |
| Full Name | Lester W Cannon Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1935 E 5600 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Lester W Cannon (OWNER) |
| Authorized Official Contact | 8012774049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lester W Cannon Dds Pc 1935 E 5600 S Salt Lake City UT 84121-1351 Ph: (801) 277-4049 | Lester W Cannon Dds Pc 1935 E 5600 S Salt Lake City UT 84121-1351 Ph: (801) 277-4049 |
| NPI Number | 1427278019 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 04/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427278019 | NPI | - | NPPES |
| 528689625000 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1364589922 (Utah) | Primary |
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