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General NPI Number Information
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NPI Number | 1629982475
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Entity Type | Organization
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Legal Business Name | WEEKEND DENTAL MERIDIAN, LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 3250 N LESLIE WAY STE 100
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City | MERIDIAN
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State | ID
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Zip | 83646-5362
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Country | US
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Telephone | 208-845-0321
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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 | OWNER
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Name | MATTHEW TUFT
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Credential | DDS
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Telephone | 208-845-0321
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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 | NULL
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