| Schweppe Pediatric Dental | |
|
5685 S 1475 E Ste 3a South Ogden UT 84403-4598 | |
| (801) 479-9220 | |
| (801) 479-0837 |
| Full Name | Schweppe Pediatric Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5685 S 1475 E Ste 3a, South Ogden, Utah |
| Authorized Official Name and Position | Mathew D Schweppe (OWNER) |
| Authorized Official Contact | 8014799220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Schweppe Pediatric Dental 5685 S 1475 E Ste 3a South Ogden UT 84403-4598 Ph: (801) 479-9220 | Schweppe Pediatric Dental 5685 S 1475 E Ste 3a South Ogden UT 84403-4598 Ph: (801) 479-9220 |
| NPI Number | 1710545769 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710545769 | NPI | - | NPPES |
| 1141007-00 | Medicaid | WY | |
| 517747532013 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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