Whalio Doctors

NPI 1003016536

Adam Richard van Leeuwen, DDS

Practitioner General Practice Dentistry Salt Lake City, UT

Practice location

Address
6936 South 2475 East 201, Salt Lake City, UT 84121-5999
Phone
(801) 943-1612
Fax
(801) 942-6008
Mailing address
6936 South 2475 East 201, Salt Lake City, UT 84121-9999

Registered specialties

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence 6610915 (UT)

Registry record

NPI
1003016536
Entity type
Individual
Sex (as registered)
Male
NPI issued
23 Jul 2007
Record last updated
23 Jul 2007

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.