Individual
JEFFREY SCHWEPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5685 S 1475 E STE 3A, SOUTH OGDEN, UT 84403-4598
(801) 479-9220
Mailing address
5685 S 1475 E STE 3A, SOUTH OGDEN, UT 84403-4598
(801) 479-9220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12013033A
IN
1223P0221X
Pediatric Dentistry
Primary
11166856-9924
UT
390200000X
Student in an Organized Health Care Education/Training Program
LDR170180
IN
Other
Enumeration date
06/20/2017
Last updated
07/07/2022
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