Individual
GARY BRENT WIEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
168 W 800 N, PROVO, UT 84601-1624
(801) 374-8205
(801) 374-8215
Mailing address
168 W 800 N, PROVO, UT 84601-1624
(801) 374-8205
(801) 374-8215
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
142629
UT
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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