Basic Information
| Provider Information | |||||||||
| NPI: | 1609883677 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIBLER | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WORD | ||||||||
| OtherFirstName: | JEANNE | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2549 SILVER CLOUD CT | ||||||||
| Address2: | |||||||||
| City: | PARK CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1580 EAST 3900 SOUTH | ||||||||
| Address2: | #110 | ||||||||
| City: | SALT LAKE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012728555 | ||||||||
| FaxNumber: | 8012721825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0221X | 144222 | UT | Y | Dental Providers | Dentist | Pediatric Dentistry |
No ID Information.