| Custom Orthodontics | |
|
255 N 3000 W Ste B West Point UT 84015-7493 | |
| (801) 825-2208 | |
| Not Available |
| Full Name | Custom Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 255 N 3000 W Ste B, West Point, Utah |
| Authorized Official Name and Position | Brady M Thomson (OWNER/ORTHODONTIST) |
| Authorized Official Contact | 4357521320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Orthodontics 255 N 3000 W Ste B West Point UT 84015-7493 Ph: (801) 825-2208 | Custom Orthodontics 255 N 3000 W Ste B West Point UT 84015-7493 Ph: (801) 825-2208 |
| NPI Number | 1326580283 |
|---|---|
| Provider Enumeration Date | 11/09/2016 |
| Last Update Date | 11/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326580283 | NPI | - | NPPES |
| 1801085063 | Medicaid | UT | |
| 1912998725 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (Utah) | Primary |