Provider Demographics
NPI:1871749135
Name:RICH, JOHN PERRY III (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PERRY
Last Name:RICH
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7086 S HIGHLAND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3768
Mailing Address - Country:US
Mailing Address - Phone:801-942-5520
Mailing Address - Fax:
Practice Address - Street 1:7086 S HIGHLAND DR STE 100
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3768
Practice Address - Country:US
Practice Address - Phone:801-942-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT668673-89031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice