Individual
DR. WELLS BROCKBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5334 S WOODROW ST # 201, MURRAY, UT 84107-5838
(801) 942-8686
Mailing address
5334 S WOODROW ST # 201, MURRAY, UT 84107-5838
(801) 942-8686
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
9073643
UT
Other
Enumeration date
09/19/2014
Last updated
02/17/2021
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