Healthcare Provider Details

I. General information

NPI: 1750091948
Provider Name (Legal Business Name): HILDALE DENTAL - ACCELERATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 W UTAH AVE
HILDALE UT
84784
US

IV. Provider business mailing address

PO BOX 841632
HILDALE UT
84784
US

V. Phone/Fax

Practice location:
  • Phone: 435-218-7172
  • Fax: 435-200-9416
Mailing address:
  • Phone: 435-218-7172
  • Fax: 435-200-9416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT R PERRY
Title or Position: OWNER
Credential: DDS
Phone: 435-218-7172