Ernest Adam Sego

Individual provider Active NPI General Practice Dentistry · Smithfield, UT

NPI 1083075733 · NPPES record last updated Mar 9, 2016

Key facts

NPI
1083075733
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
9450098-9922 (UT)
Practice address
1189 South Main
Smithfield, UT 84335
Phone
(435) 563-3025
NPI assigned
Mar 9, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9450098-9922UTMDGeneral Practice Dentistry

Networks

  • UT PPO D-SNP

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9450098-9922 UT Yes

Addresses

Primary practice location

1189 South Main
Smithfield, UT 84335

Mailing address

1189 South Main
Smithfield, UT 84335
Phone (435) 563-3025

Other providers in Smithfield, UT

All providers in Smithfield, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.