Organization
EDDIE FADDIS, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE FADDIS DDS (PRESIDENT)
(801) 785-8835
Entity
Organization
Contact information
Practice address
533 W STATE RD, STE 202, PLEASANT GROVE, UT 84062-2114
(801) 785-8835
(801) 785-9629
Mailing address
533 W STATE RD, STE 202, PLEASANT GROVE, UT 84062-2114
(801) 785-8835
(801) 785-9629
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
145625
UT
Other
Enumeration date
05/14/2012
Last updated
12/11/2015
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