Organization
HM SALT LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED HEPWORTH (OWNER)
(801) 702-7478
Entity
Organization
Contact information
Practice address
7138 S HIGHLAND DR STE 214, SALT LAKE CITY, UT 84121-3783
(810) 942-7770
Mailing address
7138 S HIGHLAND DR STE 214, SALT LAKE CITY, UT 84121-3783
(810) 942-7770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
94365969922
UT
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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