Provider Demographics
NPI:1932473188
Name:ALL AROUND DENTAL CARE
Entity Type:Organization
Organization Name:ALL AROUND DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-356-8420
Mailing Address - Street 1:777 N 500 W
Mailing Address - Street 2:106
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1541
Mailing Address - Country:US
Mailing Address - Phone:801-356-8420
Mailing Address - Fax:801-356-8510
Practice Address - Street 1:777 N 500 W
Practice Address - Street 2:106
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-1541
Practice Address - Country:US
Practice Address - Phone:801-356-8420
Practice Address - Fax:801-356-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT518503145004Medicaid