Herrod, Niles Walter
Herrod, Niles Walter is an individual health care provider with primary practice located at 777 N 500 W Suite 102, Provo UT 84601-1541. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Herrod, Niles Walter can be contacted via phone (801) 375-4707.Contact Information
Primary practice address
777 N 500 W Suite 102
Provo UT 84601-1541
Phone: (801) 375-4707
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 1321679924 | Utah |
Profile Details
| NPI number | 1578646642 |
|---|---|
| LBN Legal business name | Herrod, Niles Walter |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578646642 | NPPES |
| Other | 20859 | IHC |
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