Provider Demographics
NPI:1740807908
Name:PITCHER, DREW (DMD)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:PITCHER
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 1:23 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:HELPER
Mailing Address - State:UT
Mailing Address - Zip Code:84526-1528
Mailing Address - Country:US
Mailing Address - Phone:385-204-1986
Mailing Address - Fax:
Practice Address - Street 1:48 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HELPER
Practice Address - State:UT
Practice Address - Zip Code:84526-1560
Practice Address - Country:US
Practice Address - Phone:435-201-6940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8357872-99231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice