Custom Orthodontics
Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · West Point, UT
NPI 1326580283 · NPPES record last updated Nov 9, 2016
Key facts
- NPI
- 1326580283
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- Legal business name
- CUSTOM ORTHODONTICS
- Practice address
- 255 N 3000 W Ste B
West Point, UT 84015-7493 - Phone
- (801) 825-2208
- NPI assigned
- Nov 9, 2016
- Organization subpart
- No
Authorized official
- Name
- Brady M Thomson, DDS
- Title
- Owner/Orthodontist
- Phone
- (435) 752-1320
National Provider Directory
Locations
255 N 3000 W
Ste B
West Point, UT 84015
Phone (801) 825-2201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | UT | Yes |
Addresses
Primary practice location
255 N 3000 W Ste B
West Point, UT 84015-7493
Mailing address
255 N 3000 W Ste B
West Point, UT 84015-7493
Phone (801) 825-2208
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801085063 | Medicaid | UT | |
| 1912998725 | Medicaid | UT |
Other providers in West Point, UT
- Bradley J Clark
- Seth Robert Cope
- Margo Crane
- Crison Foot Care PLLC
- Gretel K Crison
- Lea Davis
- Keith Deagostine
- Rachel B Edwards
- Family Tree at West Point, LLC
- Matt Scott Francom
All providers in West Point, UT · Orthodontics and Dentofacial Orthopedics Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.