Individual
DR. JEREM PITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
281 S MAIN ST, CENTERVILLE, UT 84014-2292
(801) 295-6192
(801) 295-6011
Mailing address
281 S MAIN ST, CENTERVILLE, UT 84014-2292
(801) 295-6192
(801) 295-6011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4929494-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49294949900001
BLUE CROSS BLUE SHEILD
UT
Enumeration date
06/20/2007
Last updated
07/08/2007
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