| Slpd Herriman | |
|
5532 Main St Ste 220 Herriman UT 84096-5841 | |
| (801) 463-1900 | |
| Not Available |
| Full Name | Slpd Herriman |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5532 Main St Ste 220, Herriman, Utah |
| Authorized Official Name and Position | David Gustafson (DENTIST/OWNER) |
| Authorized Official Contact | 8014631900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Slpd Herriman 5532 Main St Ste 220 Herriman UT 84096-5841 Ph: () - | Slpd Herriman 5532 Main St Ste 220 Herriman UT 84096-5841 Ph: (801) 463-1900 |
| NPI Number | 1134052939 |
|---|---|
| Provider Enumeration Date | 06/03/2026 |
| Last Update Date | 06/03/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134052939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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