Provider Demographics
NPI:1306036181
Name:WEST, DANIEL W (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:WEST
Suffix:
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 1:5292 COLLEGE DR
Mailing Address - Street 2:STE. 203
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2672
Mailing Address - Country:US
Mailing Address - Phone:801-266-3000
Mailing Address - Fax:
Practice Address - Street 1:5292 COLLEGE DR
Practice Address - Street 2:STE. 203
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2672
Practice Address - Country:US
Practice Address - Phone:801-266-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA559701223G0001X
UT7421816-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice