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Organization

MOUNT OGDEN DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DERALD W GEDDES D.D.S. (AUTHORIZED REPRESENTATIVE)
(801) 394-5554
Entity
Organization

Contact information

Practice address
12320 33RD STREET, SUITE D, OGDEN, UT 84403
(801) 394-5554
(801) 394-2893
Mailing address
1220 33RD STREET, SUITE D, OGDEN, UT 84403
(801) 394-5554
(801) 394-2893

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
144437
UT

Other

Enumeration date
11/16/2009
Last updated
11/20/2009
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