Individual
DEREK R PREBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3875 CERRILLOS RD, SANTA FE, NM 87507-4145
(801) 971-5881
Mailing address
4460 S ROGER DR, SALT LAKE CITY, UT 84124-3847
(801) 971-5881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5991972-9922
UT
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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