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NPI Code Detail

MEDICARE: DAVID VERNON YOUNG D.D.S., M.D.S.

MEDICARE:   DAVID VERNON YOUNG  D.D.S., M.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry144139UT

General Provider Information

NPI Number : 1629295050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID VERNON YOUNG D.D.S., M.D.S.
Provider Business Mailing Address
First Line : 5102 COTTONWOOD LN
Second Line :
City : HOLLADAY
State : UT
Zip : 84117-7102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 622 E 4500 S STE 202
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107-2922
Country : US
Telephone Number : 801-266-3578
Fax Number : 801-268-0444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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Directions to “ DAVID VERNON YOUNG D.D.S., M.D.S.” Practice Location

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