Provider Demographics
NPI:1407089543
Name:GUENTER, ROBERT JEREMY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEREMY
Last Name:GUENTER
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 1:204 E 400 N STE C
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:UT
Mailing Address - Zip Code:84653-9320
Mailing Address - Country:US
Mailing Address - Phone:801-504-6133
Mailing Address - Fax:
Practice Address - Street 1:204 E 400 N STE C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:UT
Practice Address - Zip Code:84653-9320
Practice Address - Country:US
Practice Address - Phone:801-504-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7362646-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice