Individual
DR. KEVIN WIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
168 W 800 N, PROVO, UT 84601-1624
(801) 374-8205
Mailing address
565 E 900 S, OREM, UT 84097-7158
(801) 376-8189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
94297759923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326423724
ORGANIZATION NPI NUMBER
NE
Enumeration date
12/05/2019
Last updated
12/05/2019
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