Provider Demographics
NPI:1750428793
Name:PEPERS, VANESSA (RDH)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PEPERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E 500 S STE C
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-3873
Mailing Address - Country:US
Mailing Address - Phone:801-292-7807
Mailing Address - Fax:801-292-9206
Practice Address - Street 1:535 E 500 S STE C
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-3873
Practice Address - Country:US
Practice Address - Phone:801-292-7807
Practice Address - Fax:801-292-9206
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3745519920124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist