Individual
SHAUN THOMAS HEWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
5742 S 1475 E STE 100, SOUTH OGDEN, UT 84403-4857
(801) 479-9070
Mailing address
5742 S 1475 E STE 100, SOUTH OGDEN, UT 84403-4857
(801) 479-9070
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12210727-9925
UT
390200000X
Student in an Organized Health Care Education/Training Program
2901021498
MI
Other
Enumeration date
07/10/2015
Last updated
06/24/2021
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