| Dennis L Dedecker Dds Pc | |
|
2185 N 1700 W #204 Layton UT 84041-1192 | |
| (801) 773-9790 | |
| (801) 773-9792 |
| Full Name | Dennis L Dedecker Dds Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2185 N 1700 W, Layton, Utah |
| Authorized Official Name and Position | Dennis L Dedecker (ORAL AND MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 8017739790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis L Dedecker Dds Pc 2185 N 1700 W #204 Layton UT 84041-1192 Ph: (801) 773-9790 | Dennis L Dedecker Dds Pc 2185 N 1700 W #204 Layton UT 84041-1192 Ph: (801) 773-9790 |
| NPI Number | 1578748190 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 06/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578748190 | NPI | - | NPPES |
| 107004925101 | Other | UT | SELECTHEALTH |
| 190000851 | Other | UT | RAILROAD MEDICARE |
| 000002181 | Other | UT | MEDICARE PROVIDER# |
| 52970991500001 | Other | UT | BLUECROSS BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 135665 9924 (Utah) | Primary |
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