Provider Demographics
NPI:1497945711
Name:HIBBERT, STEVE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:HIBBERT
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 1:1747 HERITAGE LN
Mailing Address - Street 2:STE B202
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-8552
Mailing Address - Country:US
Mailing Address - Phone:801-614-0099
Mailing Address - Fax:
Practice Address - Street 1:1747 HERITAGE LN
Practice Address - Street 2:STE B202
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-8552
Practice Address - Country:US
Practice Address - Phone:801-614-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1924553599231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry