Provider Demographics
NPI:1023801370
Name:SKINNER, CADEN BRETT (DMD)
Entity type:Individual
Prefix:
First Name:CADEN
Middle Name:BRETT
Last Name:SKINNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 N SARAH ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9231
Mailing Address - Country:US
Mailing Address - Phone:435-265-6985
Mailing Address - Fax:
Practice Address - Street 1:1260 N 200 E STE 3
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2382
Practice Address - Country:US
Practice Address - Phone:435-792-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14223684-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist