Provider Demographics
NPI:1851768063
Name:VAL HEBERT RDH INC
Entity Type:Organization
Organization Name:VAL HEBERT RDH INC
Other - Org Name:GRINS FOR EVERYONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTRAUD
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-444-7030
Mailing Address - Street 1:3816 W 13400 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6642
Mailing Address - Country:US
Mailing Address - Phone:385-444-7030
Mailing Address - Fax:
Practice Address - Street 1:3816 W 13400 S
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-6642
Practice Address - Country:US
Practice Address - Phone:385-444-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRINS FOR EVERYONE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-24
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental