Organization
JEPPSON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE C JEPPSON DMD (PRESIDENT)
(801) 356-7701
Entity
Organization
Contact information
Practice address
86 N UNIVERSITY AVE STE 280, PROVO, UT 84601-5658
(801) 356-7701
Mailing address
86 N UNIVERSITY AVE STE 280, PROVO, UT 84601-5658
(801) 356-7701
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2946929922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
GENERAL DENTIST
UT
Enumeration date
09/14/2006
Last updated
08/11/2009
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