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NPI Code Detail

MEDICARE: DR. CHET RAY COLEMAN D.D.S.

MEDICARE:  DR. CHET RAY COLEMAN  D.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
11223G0001XGeneral Practice Dentistry144366-9922UT

General Provider Information

NPI Number : 1811903826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHET RAY COLEMAN D.D.S.
Provider Business Mailing Address
First Line : 3165 W 4700 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84118-2525
Country : US
Telephone Number : 801-966-9956
Fax Number : 801-969-7004
Provider Business Practice Location Address
First Line : 3165 W 4700 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84118-2525
Country : US
Telephone Number : 801-966-9956
Fax Number : 801-969-7004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CHET RAY COLEMAN D.D.S.” Practice Location

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