Provider Demographics
NPI:1073740148
Name:VUITTONET, CHANCI SHEREE (RDH)
Entity Type:Individual
Prefix:
First Name:CHANCI
Middle Name:SHEREE
Last Name:VUITTONET
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5642 S 900 E STE 6
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1181
Mailing Address - Country:US
Mailing Address - Phone:801-261-2202
Mailing Address - Fax:
Practice Address - Street 1:5642 S 900 E STE 6
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1181
Practice Address - Country:US
Practice Address - Phone:801-261-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7025334-9920124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist