Provider Demographics
NPI:1043427453
Name:PINCOCK, DAVID W I (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:PINCOCK
Suffix:I
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1694 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2542
Mailing Address - Country:US
Mailing Address - Phone:801-762-0100
Mailing Address - Fax:801-762-0101
Practice Address - Street 1:1694 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2542
Practice Address - Country:US
Practice Address - Phone:801-762-0100
Practice Address - Fax:801-762-0101
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4936843-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice