Individual
EDWARD ANTHONY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
613 COUNTRY CLUB DR, TOOELE, UT 84074-9655
(208) 201-0354
Mailing address
613 COUNTRY CLUB DR, TOOELE, UT 84074-9655
(208) 201-0354
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14286615-9926
UT
122300000X
Dentist
Primary
38773
TX
Other
Enumeration date
08/03/2022
Last updated
05/20/2026
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