Individual
JESSICA BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, BS
Contact information
Practice address
13073 S PLUM GROVE CT, HERRIMAN, UT 84096-5763
(801) 906-1619
Mailing address
13073 S PLUM GROVE CT, HERRIMAN, UT 84096-5763
18019061619
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
9041914-9920
UT
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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