Intermountain Dental Associates - Surgical Associates
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · North Ogden, UT
NPI 1598033409 · NPPES record last updated Dec 6, 2011
Key facts
- NPI
- 1598033409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 144024-9922 (UT)
- Legal business name
- INTERMOUNTAIN DENTAL ASSOCIATES - SURGICAL ASSOCIATES
- Practice address
- 2721 N 400 E
Suite 2
North Ogden, UT 84414-2393 - Phone
- (801) 782-5682
- Fax
- (801) 786-0520
- NPI assigned
- Dec 6, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- INTERMOUNTAIN DENTAL ASSOCIATES SPECIALTY LLC
Authorized official
- Name
- Vicki Lewis
- Title
- Specialist Coordinator
- Phone
- (801) 782-5682
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | 144024-9922 | UT | Yes |
Addresses
Primary practice location
2721 N 400 E
Suite 2
North Ogden, UT 84414-2393
Mailing address
2721 N 400 E
Suite 2
North Ogden, UT 84414-2393
Phone (801) 782-5682
Other providers in North Ogden, UT
- Trace R Hellstrom
- Dana Lee Hernandez
- Tami Hunter
- Ihc Health Services Inc
- Independence Home Care, LLC
- Intermountain Dental Associates -Ortho-MTN View
- Intermountain Dental Associates -Periodontics
- Intermountain Dental Associates- Ortho- Cache Valley
- Intermountain Dental Associates-Endodontics
- Amanda Anne Jensen
All providers in North Ogden, UT · Oral and Maxillofacial Surgery (Dentist) in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2011. 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.