Brad A Wahlstrom in West Jordan - General Practice
Brad A Wahlstrom - NPI 1861572455
Brad A Wahlstrom is a General Practice in West Jordan, Utah. Brad A Wahlstrom practices all healthcare services and medical treatments related to General Practice. The NPI Number for Brad A Wahlstrom is 1861572455. The last update date is 2007-07-08.
Brad A Wahlstrom's current location address is 7089 Redwood Rd, West Jordan, Utah. You can contact this provider via phone number 8015663003 and fax number 8015681710. The mailing address for Brad A Wahlstrom is 7089 Redwood Rd, West Jordan, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brad A Wahlstrom |
|---|---|
| Address | 7089 Redwood Rd, West Jordan, Utah |
| Phone Number | 8015663003 |
| Fax Number | 8015681710 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1861572455 |
|---|---|
| Provider Enumeration Date | 2006-10-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 7089 Redwood Rd |
|---|---|
| City | West Jordan |
| State | Utah (UT) |
| Post Code | 840843420 |
| Phone Number | 8015663003 |
| Fax Number | 8015681710 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 4791609 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the Brad A Wahlstrom's unique identification number?
The Brad A Wahlstrom has been assigned the NPI (National Provider Identifier) Number 1861572455 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Brad A Wahlstrom's physical address?
The Brad A Wahlstrom is physically located at 7089 Redwood Rd, in the city of West Jordan, UT, with the postal code 840843420.
What is the Brad A Wahlstrom's area of specialization and corresponding taxonomy classification?
The Brad A Wahlstrom's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did the Brad A Wahlstrom receive its 1861572455 assignment from the Centers for Medicare & Medicaid Services?
The Brad A Wahlstrom was assigned its 1861572455 by the Centers for Medicare & Medicaid Services on 2006-10-17.
When was the information pertaining to Brad A Wahlstrom most recently updated or revised?
The details related to Brad A Wahlstrom, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.