OrganizationActive
Intermountain Dental Associates -Periodontics
NPI 1093083990 · Periodontics · North Ogden, UT
Provider details
- NPI number
- 1093083990
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Parent organization
- Intermountain Dental Associates Specialty
- Organization subpart
- Yes
- Authorized official
- Vicki Lewis, Specialist Coordinator(801) 782-5682
- License
- 144024-9922 (UT)
Specialties & taxonomies
Dental Providers
Practice location
2721 N 400 E
Suite 2
North Ogden, UT 84414-2393
Phone: (801) 782-5682
Fax: (801) 786-0520
Approximate (ZIP-level) locationGet directions
Mailing address
2721 N 400 E
North Ogden, UT 84414-2393
Registry dates
- Enumerated
- 2011-12-06
- Last updated
- 2011-12-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.