Individual
GORDON HOWARD WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4535 S 5600 W, WEST VALLEY CITY, UT 84120-4639
(801) 969-8243
(801) 840-5200
Mailing address
12938 RIVERTON FARMS WAY, RIVERTON, UT 84065
(801) 254-4140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
143977-9921
UT
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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