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Individual
DENNIS DEDECKER
Active
Individual
DENNIS DEDECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PC
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1356659924
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000058020
MEDICARE GROUP
UT
01
—
107004925101
SELECTHEALTH #
UT
01
—
190000851
RAILROAD MEDICARE #
UT
01
—
190644
UNITED CONCORDIA #
UT
01
—
35697
DMBA PROVIDER #
UT
01
—
43-00008
UNITEDHEALTH CARE (UHC) #
UT
01
—
64163
PUBLIC EMPLOYEES (PEHP) #
UT
01
—
870344080DE1
EDUCATORS MUTUAL #
UT
Enumeration date
05/27/2005
Last updated
04/05/2011
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