Individual
DR. ADAM RICHARD VAN LEEUWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6936 SOUTH 2475 EAST, 201, SALT LAKE CITY, UT 84121-5999
(801) 943-1612
(801) 942-6008
Mailing address
6936 SOUTH 2475 EAST, 201, SALT LAKE CITY, UT 84121-9999
(801) 943-1612
(801) 942-6008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6610915
UT
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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