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Organization

UTAH DENTAL ANESTHESIA PLLC

Active
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Organization

UTAH DENTAL ANESTHESIA PLLC

Active
Parent organization
IDAHO ADVANCED DENTAL ANESTHESIA, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
IDAHO ADVANCED DENTAL ANESTHESIA, LLC
Authorized official
DR. JAKE WOOD DMD, MPH (OWNER)
(208) 559-5518
Entity
Organization

Contact information

Practice address
1028 W 950 N STE 102, OREM, UT 84057-4171
(208) 559-5518
Mailing address
1310 S VISTA AVE, SUITE 21, BOISE, ID 83705
(208) 559-5518

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary

Other

Enumeration date
07/23/2026
Last updated
07/23/2026
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