Healthcare Provider Details

I. General information

NPI: 1972695583
Provider Name (Legal Business Name): LAMONT E HESSELGESSER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 N 1600 W
PLEASANT VIEW UT
84404-6900
US

IV. Provider business mailing address

2703 N 1600 W
PLEASANT VIEW UT
84404-6900
US

V. Phone/Fax

Practice location:
  • Phone: 801-737-4650
  • Fax: 801-737-4653
Mailing address:
  • Phone: 801-737-4650
  • Fax: 801-737-4653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number94-260456-9922
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: