| Layton Oral Surgery, P.c. | |
|
2185 N. 1700 W. #204 Layton UT 84041 | |
| (801) 773-9790 | |
| Not Available |
| Full Name | Layton Oral Surgery, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 2185 N. 1700 W., Layton, Utah |
| Authorized Official Name and Position | Dayne Jensen (OWNER) |
| Authorized Official Contact | 8016987121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Layton Oral Surgery, P.c. 2185 N. 1700 W. #204 Layton UT 84041 Ph: () - | Layton Oral Surgery, P.c. 2185 N. 1700 W. #204 Layton UT 84041 Ph: (801) 773-9790 |
| NPI Number | 1770238016 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 02/15/2022 |
| Medicare PECOS PAC ID | 0244622538 |
|---|---|
| Medicare Enrollment ID | O20220228001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770238016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Dennis L Dedecker |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073516688 PECOS PAC ID: 3678501921 Enrollment ID: I20050729000207 |
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