Organization
IVERSON DENTAL, INC.
Active
Other names
Iverson Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERN Q. IVERSON DDS (OWNER)
(801) 745-3882
Entity
Organization
Contact information
Practice address
2627 N HIGHWAY 162, EDEN, UT 84310-9745
(801) 745-3882
(801) 745-6207
Mailing address
PO BOX 900, EDEN, UT 84310-0900
(801) 745-3882
(801) 745-6207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1338754-0142
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487617940
—
UT
Enumeration date
09/30/2013
Last updated
09/30/2013
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