Individual
DR. TIMOTHY B. ELISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3556 W 9800 S, SUITE 103, SOUTH JORDAN, UT 84095-3211
(801) 446-3549
(801) 254-3656
Mailing address
3556 W 9800 S, SUITE 103, SOUTH JORDAN, UT 84095-3211
(801) 446-3549
(801) 254-3656
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4761040-9922
UT
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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