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General NPI Number Information
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NPI Number | 1720480411
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Entity Type | Organization
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Legal Business Name | HURRICANE PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 48 S 2500 W STE 230
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City | HURRICANE
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State | UT
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Zip | 84737-3381
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Country | US
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Telephone | 435-635-7200
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Fax | 435-635-1444
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Provider Business Mailing Address
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Address Line | 48 S 2500 W STE 230
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City | HURRICANE
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State | UT
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Zip | 84737-3381
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Country | US
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Telephone | 435-635-7200
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Fax | 435-635-1444
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Authorized Official
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Title or Position | DOCTOR
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Name | SEAN C SCHEXNAYDER
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Credential | DMD
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Telephone | 435-635-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 83400399923
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 63359359923
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License Number State | UT
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