Individual
VICTOR O PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5255 S 4015 W, SUITE 180, SALT LAKE CITY, UT 84118-4257
(801) 968-9003
Mailing address
5255 S 4015 W, SUITE 180, SALT LAKE CITY, UT 84129
(801) 968-9003
(801) 968-9069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
139135
UT
Other
Enumeration date
03/17/2007
Last updated
04/16/2014
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