Organization
INTERMOUNTAIN DENTAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN CAHOON (DDS)
(801) 560-9757
Entity
Organization
Contact information
Practice address
1747 HERITAGE LN, SYRACUSE, UT 84075-8552
(801) 841-3300
Mailing address
3150 SAWTELLE BLVD APT 308, LOS ANGELES, CA 90066-1445
(707) 490-9125
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6413227-9922
UT
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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