Provider Demographics
NPI:1497894000
Name:BAWDEN, DEAN T (DDS)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:T
Last Name:BAWDEN
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 1:7555 CENTER VIEW CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1970
Mailing Address - Country:US
Mailing Address - Phone:801-566-5681
Mailing Address - Fax:
Practice Address - Street 1:7555 CENTER VIEW CT
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-1970
Practice Address - Country:US
Practice Address - Phone:801-566-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT134645-99211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics