Wise, Dustin Bryant
Wise, Dustin Bryant is an sole proprietor health care provider with primary practice located at 1888 W 800 N , Pleasant Grove UT 84062-4097. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wise, Dustin Bryant can be contacted via phone (801) 492-7851.Contact Information
Primary practice address
1888 W 800 N
Pleasant Grove UT 84062-4097
Phone: (801) 492-7851
Fax: (801) 492-7883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 52479661205 | Utah |
Profile Details
| NPI number | 1811945769 |
|---|---|
| LBN Legal business name | Wise, Dustin Bryant |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2006 |
| Last updated | Sep 9th, 2021 - about 3 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 | 1811945769 | NPPES |
| Utah | Other | 107017722102 | IHC HEALTH PLANS |
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