NPI Profile for PROVO PDC PLLC in PROVO, UT.
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
1223G0001X | |||
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Orthotist |
222Z00000X | 55 | Individual Certified Orthotist | |
Periodontics |
1223P0300X |
| NPI Number | 1467135822 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/10/2023 | |
| Last updated | 08/10/2023 - About 3 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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PROVO PDC PLLC
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