Juan Diaz De Leon, DDS Valid NPI
Individual provider · General Practice Dentistry · Provo, UT
- NPI
- 1093206112
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 8743606-9922 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2018-05-24
- Last updated
- 2018-05-24
Practice location
2520 N University Ave Ste 101
Provo, UT 84604-6081
(801) 426-6255