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General NPI Number Information
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NPI Number | 1184234460
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Entity Type | Organization
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Legal Business Name | NICOLAS K. YOUNG, D.M.D., INC.
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 440 W 800 N
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City | OREM
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State | UT
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Zip | 84057-3728
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Country | US
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Telephone | 801-764-9444
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Fax | 801-229-2633
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Provider Business Mailing Address
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Address Line | 440 W 800 N
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City | OREM
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State | UT
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Zip | 84057-3728
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Country | US
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Telephone | 801-764-9444
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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. NICOLAS KENT YOUNG
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Credential | DMD
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Telephone | 801-310-4697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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