Individual
JACOB TUFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
530 W 465 N STE 703, PROVIDENCE, UT 84332-8006
(435) 999-0234
Mailing address
530 W 465 N STE 703, PROVIDENCE, UT 84332-8006
(801) 615-1454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13673505
UT
1223P0221X
Pediatric Dentistry
Primary
13673505
UT
1223P0221X
Pediatric Dentistry
2025044832
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2022
Last updated
10/21/2025
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