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Organization
WAYNE COMMUNITY HEALTH CENTERS, INC
Active
Organization
WAYNE COMMUNITY HEALTH CENTERS, INC
Active
Other names
EscaLante Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVAN CHRISTENSEN (CEO)
(435) 425-1102
Entity
Organization
Contact information
Practice address
65 NORTH CENTER STREET, ESCALANTE, UT 84776-0276
(435) 826-4333
(435) 826-4336
Mailing address
PO BOX 303, BICKNELL, UT 84715-0303
(435) 425-3744
(435) 425-1138
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
UT
261QF0400X
Federally Qualified Health Center (FQHC)
—
UT
261QM1300X
Multi-Specialty Clinic/Center
—
UT
Other
Enumeration date
06/28/2017
Last updated
04/21/2021
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