Wisdom Teeth Of Southern Utah

LBN: Wisdom Teeth Of Southern Utah
Wisdom Teeth Of Southern Utah is an health care organization with primary practice located at 446 S Mall Dr Ste 100 , St George UT 84790-4944. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Wisdom Teeth Of Southern Utah can be contacted via phone (435) 673-3490, or through Jensen, Dayne via phone (435) 673-3490.

Contact Information

Primary practice address
446 S Mall Dr Ste 100 St George UT 84790-4944
Phone: (435) 673-3490
Fax: (435) 627-9954
Website:
Map and Directions
Authorized official contact:
Name: Jensen, Dayne DMD MD
Phone: (435) 673-3490

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X

Profile Details

NPI number 1467916528
LBN Legal business name Wisdom Teeth Of Southern Utah
DBA Doing business as
Authorized official Jensen, Dayne DMD MD
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 23rd, 2019
Last updated Jan 23rd, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467916528 NPPES
Other 1881926509 NPI

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