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Individual

BRUCE H GODDERIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
291 SOUTH MAIN, SUITE A, SMITHFIELD, UT 84335
(435) 563-6213
(435) 563-8443
Mailing address
291 SO MAIN, SUITE A, SMITHFIELD, UT 84335
(435) 563-6213
(435) 563-8443

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1431759922
UT

Other

Enumeration date
03/20/2007
Last updated
07/08/2007
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