Healthcare Provider Details

I. General information

NPI: 1023952686
Provider Name (Legal Business Name): MVDC OGDEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 OGDEN AVE
OGDEN UT
84403-1823
US

IV. Provider business mailing address

3915 OGDEN AVE
OGDEN UT
84403-1823
US

V. Phone/Fax

Practice location:
  • Phone: 801-392-1000
  • Fax: 801-923-6218
Mailing address:
  • Phone: 801-392-1000
  • Fax: 801-923-6218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHERYL CUNDICK
Title or Position: OFFICE MANAGER
Credential:
Phone: 801-668-5336