Provider Demographics
NPI:1205846458
Name:EATON, JASON WILLIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:WILLIS
Last Name:EATON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 N. 700 W.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-525-2200
Mailing Address - Fax:801-525-8806
Practice Address - Street 1:1916 N. 700 W.
Practice Address - Street 2:SUITE 100
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-525-2200
Practice Address - Fax:801-525-8806
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4990217-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist