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General NPI Number Information
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NPI Number | 1568329340
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Entity Type | Organization
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Legal Business Name | WEEKEND DENTAL WEST VALLEY CITY LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 3454 S 4800 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-1705
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Country | US
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Telephone | 801-895-4744
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 S UNION PARK CTR STE 510
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84047-6518
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Country | US
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Telephone | 801-641-8710
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. PETER THEURER
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Credential | DDS
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Telephone | 469-525-2191
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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 |
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License Number State |
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