Most Relevant Information
Provider Data
| NPI Number: | 1003016536 |
| Provider Name: | ADAM RICHARD VAN LEEUWEN D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 6610915 |
Most Important Dates
| Enumeration Date: | 07/23/2007 |
| Last Updated: | 07/23/2007 |
Provider Practice Location
6936 SOUTH 2475 EAST
201
SALT LAKE CITY
UT
841215999
Practice Location Phone/Fax
| Phone: | 8019431612 |
| Fax: | 8019426008 |
Provider Mailing Location
6936 SOUTH 2475 EAST
201
SALT LAKE CITY
UT
841219999
Provider Mailing Phone/Fax
| Phone: | 8019431612 |
| Fax: | 8019426008 |