Wisdom Teeth Only | |
2230 N University Pkwy Ste 8a Provo UT 84604-6702 | |
(801) 370-0050 | |
Not Available |
Full Name | Wisdom Teeth Only |
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Speciality | Dentist - General Practice |
Location | 2230 N University Pkwy Ste 8a, Provo, Utah |
Authorized Official Name and Position | Raymond Heath Hendrickson (OWNER) |
Authorized Official Contact | 8013700050 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wisdom Teeth Only 2230 N University Pkwy Ste 8a Provo UT 84604-6702 Ph: (801) 370-0050 | Wisdom Teeth Only 2230 N University Pkwy Ste 8a Provo UT 84604-6702 Ph: (801) 370-0050 |
NPI Number | 1083978316 |
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Provider Enumeration Date | 07/02/2012 |
Last Update Date | 07/02/2012 |
Identifier | Type | State | Issuer |
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1083978316 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 5136599922 (Utah) | Primary |
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