IndividualActive
Jeremy Manwaring, DMD,MS
NPI 1659536225 · Periodontics · Salt Lake City, UT
Provider details
- NPI number
- 1659536225
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DMD,MS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5682796 (UT)
Specialties & taxonomies
Dental Providers
Practice location
6287 S. Redwood Road
Suite#102
Salt Lake City, UT 84123
Phone: (801) 293-8833
Fax: (801) 293-8844
Approximate (ZIP-level) locationGet directions
Mailing address
6287 S. Redwood Road
Salt Lake City, UT 84123
Registry dates
- Enumerated
- 2008-07-23
- Last updated
- 2008-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.