| Bret J Sorensen | |
|
497 N Main St Spanish Fork UT 84660-3002 | |
| (801) 798-2100 | |
| (801) 798-9977 |
| Full Name | Bret J Sorensen |
|---|---|
| Speciality | Dentist |
| Location | 497 N Main St, Spanish Fork, Utah |
| Authorized Official Name and Position | Bret J Sorensen (OWNER) |
| Authorized Official Contact | 8017982100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bret J Sorensen 497 N Main St Spanish Fork UT 84660-3002 Ph: (801) 798-2100 | Bret J Sorensen 497 N Main St Spanish Fork UT 84660-3002 Ph: (801) 798-2100 |
| NPI Number | 1174070015 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 09/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174070015 | NPI | - | NPPES |
| 529511826002 | Medicaid | UT | |
| 528178604002 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 363178-9923 (Utah) | Primary |
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