FOREVER YOUNG DENTISTRY PLLC NPI 1508236795

NPI Information

FOREVER YOUNG DENTISTRY PLLC is a dental clinic center in Provo, UT. FOREVER YOUNG DENTISTRY PLLC NPI is 1508236795. The provider is registered as an organization entity type.

The provider's business location address is:

2335 S. STATE STREET
STE #200
PROVO, UT
ZIP 84606
Phone: (801) 225-1630
Fax: (801) 225-1630

The provider's authorized official is Reyna M Madriles .
The authorized official title is Co-owner and has the following contact phone number (801) 225-1630.

The enumeration date for this NPI number is 9/30/2015 and was last updated on 9/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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