Individual
JARED HEPWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1234 N 900 E, PROVO, UT 84604-2719
(801) 854-9140
Mailing address
1234 N 900 E, PROVO, UT 84604-2719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9436596-9922
UT
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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