Organization
MATHEW D SCHWEPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW SCHWEPPE DDS (OWNER)
(801) 479-9220
Entity
Organization
Contact information
Practice address
5685 S 1475 E STE 3A, SOUTH OGDEN, UT 84403-4598
(801) 479-9220
(801) 479-0837
Mailing address
5685 S 1475 E, SOUTH OGDEN, UT 84403-4716
(801) 479-9220
(801) 479-8837
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1432269923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
517747532013
—
UT
Enumeration date
10/30/2012
Last updated
10/30/2012
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