Individual
DR. RUSSELL J GUYMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
191 N 200 E, LOGAN, UT 84321-4605
(435) 752-5991
Mailing address
191 N 200 E, LOGAN, UT 84321-4605
(435) 752-5991
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8908035
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D-4402-OR
ID
Other
Enumeration date
04/28/2010
Last updated
10/20/2014
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