Healthcare Provider Details

I. General information

NPI: 1447167234
Provider Name (Legal Business Name): ORAL HEALTH ACCESS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 E WILDERNESS GATE DR
WASHINGTON UT
84780-2582
US

IV. Provider business mailing address

2506 E WILDERNESS GATE DR
WASHINGTON UT
84780-2582
US

V. Phone/Fax

Practice location:
  • Phone: 801-747-9691
  • Fax:
Mailing address:
  • Phone: 801-747-9691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAELE BERRYMAN GREEN
Title or Position: OWNER
Credential: RDH, BS
Phone: 801-747-9691