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104 West Dental LLC — NPI 1255294765, Brigham City, UT | NPI Central

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NPI 1255294765

OrganizationActive

104 West Dental LLC

NPI 1255294765 · General Practice Dentistry · Brigham City, UT

Provider details

NPI number: 1255294765
Entity type: Organization
Primary specialty: General Practice DentistryDental Providers
Authorized official: Daniel Nelson, Member

Practice location

104 W 200 S

Brigham City, UT 84302-2506

Phone: (435) 734-2394

Fax: (435) 734-0117

More UT providers

Mailing address

104 W 200 S

Brigham City, UT 84302-2506

Registry dates

Enumerated: 2025-12-03
Last updated: 2025-12-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.