Organization
WADE PEERS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADE A PEERS D.D.S. (OWNER)
(435) 615-9840
Entity
Organization
Contact information
Practice address
2750 RASMUSSEN RD STE 106, PARK CITY, UT 84098-5401
(435) 615-9840
(435) 615-9842
Mailing address
2750 RASMUSSEN RD STE 106, PARK CITY, UT 84098-5401
(435) 615-9840
(435) 615-9842
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
98362987
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000063649
MEDICARE PTAN
UT
Enumeration date
02/03/2010
Last updated
03/16/2010
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