Organization · Type 2 NPI

Forever Young Dentistry PLLC

Dental Clinic/Center · Provo, UT

NPI number 1508236795 Active

Practice location

2335 S. State Street, Ste #200
Provo, UT 84606

Call (801) 225-1630 Map

Fax (801) 225-1630

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

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About NPI 1508236795

Forever Young Dentistry PLLC's National Provider Identifier is 1508236795, issued on Sep 30, 2015. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Provo, UT. The record was last updated on Sep 30, 2015.