Spencer N Diehl, DMD
Individual provider Active NPI General Practice Dentistry · Midway, UT
NPI 1336989607 · NPPES record last updated May 25, 2024
Key facts
- NPI
- 1336989607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 139961049923 (UT)
- Practice address
- 210 E Main St Ste 201
Midway, UT 84049-6817 - Phone
- (435) 654-2822
- NPI assigned
- May 25, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 139961049923 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prince Dental Group PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 139961049923 | UT | Yes |
Addresses
Primary practice location
210 E Main St Ste 201
Midway, UT 84049-6817
Mailing address
629 W 250 N
Lindon, UT 84042-1344
Phone (385) 201-8816
Other providers in Midway, UT
- Neil Drew Christensen
- ZD Chudyba
- Krista Jean Clark
- Jack L Cox
- Diamond Springs Wellness Center PC
- Duane E Townsend a Professional Corporation
- Kathy Felt
- Sarah E. Firmage
- Anna Fisher
- Anne Marie Fitzgerald
All providers in Midway, UT · General Practice 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 May 25, 2024. 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.