| Simply Wisdom Teeth Pllc | |
|
352 E Riverside Dr Ste A9 Saint George UT 84790-5812 | |
| (435) 652-1243 | |
| (435) 652-1243 |
| Full Name | Simply Wisdom Teeth Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 352 E Riverside Dr Ste A9, Saint George, Utah |
| Authorized Official Name and Position | Niels Hendrickson (MANAGER) |
| Authorized Official Contact | 4352156621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Simply Wisdom Teeth Pllc 352 E Riverside Dr Ste A9 Saint George UT 84790-5812 Ph: (435) 652-1243 | Simply Wisdom Teeth Pllc 352 E Riverside Dr Ste A9 Saint George UT 84790-5812 Ph: (435) 652-1243 |
| NPI Number | 1255857728 |
|---|---|
| Provider Enumeration Date | 08/16/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255857728 | NPI | - | NPPES |
| 528948205 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 143297 (Utah) | Primary |
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