| |
427 S Main St Ste 101 Cedar City UT 84720 | |
(435) 586-6526 | |
(435) 867-9203 |
Full Name | |
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Speciality | Dentist |
Location | 427 S Main St, Cedar City, Utah |
Authorized Official Name and Position | Shad L Morris (OWNER) |
Authorized Official Contact | 4355866526 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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427 S Main St Ste 101 Cedar City UT 84720 Ph: (435) 586-6526 | 427 S Main St Ste 101 Cedar City UT 84720 Ph: (435) 586-6526 |
NPI Number | 1902967524 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902967524 | NPI | - | NPPES |
S29980447007 | Medicaid | UT | |
02800149900001 | Other | UT | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 02800149922 (Utah) | Primary |
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