Provider Demographics
NPI:1740054410
Name:TAWZER DENTAL
Entity type:Organization
Organization Name:TAWZER DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-753-1686
Mailing Address - Street 1:550 W 465 N UNIT 501
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-8015
Mailing Address - Country:US
Mailing Address - Phone:435-753-1686
Mailing Address - Fax:435-750-6736
Practice Address - Street 1:550 W 465 N UNIT 501
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-8015
Practice Address - Country:US
Practice Address - Phone:435-753-1686
Practice Address - Fax:435-750-6736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental