NPI 1184132623

Academy Dental LLC

Organisation Advanced Practice Dental Therapist Provo, UT

Practice location

Address: 488 N 100 E St., Provo, UT 84606
Phone: (801) 374-0867

Authorised official

Name: Corbin Matthews
Title: Owner
Phone: (801) 473-6455

Registered specialties (2)

Advanced Practice Dental Therapist Primary

Dental Providers Taxonomy 125K00000X Licence 372923 (UT)

Other Advanced Practice Dental Therapist providers in Utah →

Advanced Practice Dental Therapist

Dental Providers Taxonomy 125K00000X Licence 8372408-9922 (UT)

Registry record

NPI: 1184132623
Entity type: Organization
NPI issued: 18 Jan 2018
Record last updated: 18 Jan 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.