Provider Demographics
NPI:1720496714
Name:PEERY, SVEN LEE (DMD)
Entity Type:Individual
Prefix:
First Name:SVEN
Middle Name:LEE
Last Name:PEERY
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 1:517 W 100 N STE 210
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9826
Mailing Address - Country:US
Mailing Address - Phone:435-755-6061
Mailing Address - Fax:435-994-8362
Practice Address - Street 1:1515 N 400 E
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7561
Practice Address - Country:US
Practice Address - Phone:435-755-6061
Practice Address - Fax:435-755-6091
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-4816122300000X
UT9037688-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist