Provider Demographics
NPI:1063492981
Name:VIEHWEG, TATE LOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:TATE
Middle Name:LOTT
Last Name:VIEHWEG
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:3300 RUNNING CREEK WAY
Mailing Address - Street 2:BUILDING H SUITE 210
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5563
Mailing Address - Country:US
Mailing Address - Phone:801-766-4834
Mailing Address - Fax:801-766-4834
Practice Address - Street 1:3300 N RUNNING CREEK WAY
Practice Address - Street 2:BUILDING H SUITE 210
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5563
Practice Address - Country:US
Practice Address - Phone:801-766-4834
Practice Address - Fax:801-766-4834
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL51341223S0112X
WADE000103821223S0112X
UT6632857204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery