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General NPI Number Information
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NPI Number | 1073553475
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Entity Type | Individual
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Provider Name | DR. JOHN ENGH STORHEIM SR.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1345 E 3900 S
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City | SLC
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State | UT
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Zip | 84124-1474
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Country | US
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Telephone | 801-272-8284
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Fax | 807-277-4387
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Provider Business Mailing Address
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Address Line | 1345 E 3900 S
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City | SLC
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State | UT
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Zip | 84124-4416
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Country | US
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Telephone | 801-272-8284
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Fax | 807-277-4387
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 134239-9922
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License Number State | UT
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