Provider Demographics
NPI:1457794315
Name:VEST, KURT GORDON (DMD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:GORDON
Last Name:VEST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W 465 N STE 703
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-8006
Mailing Address - Country:US
Mailing Address - Phone:435-999-0234
Mailing Address - Fax:435-514-1743
Practice Address - Street 1:169 N GATEWAY DR STE 105
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9861
Practice Address - Country:US
Practice Address - Phone:435-999-0234
Practice Address - Fax:435-514-1743
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8610890-99231223P0221X
UT86108901223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry