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General NPI Number Information
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NPI Number | 1093838377
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Entity Type | Organization
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Legal Business Name | CEDAR VIEW PEDIATRIC DENITSTRY
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1251 NORTHFIELD RD 201
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City | CEDAR CITY
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State | UT
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Zip | 84720-8916
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Country | US
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Telephone | 435-586-8188
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Fax |
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Provider Business Mailing Address
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Address Line | 1251 NORTHFIELD RD 201
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City | CEDAR CITY
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State | UT
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Zip | 84720-8916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TYLER ROBERT ALBRECHT
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Credential | DMD
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Telephone | 435-586-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 63359359921
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License Number State | UT
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