Individual
DR. WADE F STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1073 BRYAN AVE, SALT LAKE CITY, UT 84105-2401
(804) 814-7083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
67174419922
UT
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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