Individual
JORDAN HEIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1386 S GREEN ST, SALT LAKE CITY, UT 84105-2137
(815) 262-6525
Mailing address
1386 S GREEN ST, SALT LAKE CITY, UT 84105-2137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11013670-9921
UT
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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