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General NPI Number Information
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NPI Number | 1912899535
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Entity Type | Organization
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Legal Business Name | WELLSVILLE FAMILY DENTAL
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 51 E MAIN ST
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City | WELLSVILLE
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State | UT
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Zip | 84339-9558
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Country | US
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Telephone | 435-245-6035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | WELLSVILLE
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State | UT
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Zip | 84339-0007
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Country | US
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Telephone | 435-245-6035
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | JOSHUA KING
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Credential | D.M.D
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Telephone | 435-245-6035
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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 |
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License Number State |
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