Individual
THAYNE HENRIE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1268 W SOUTH JORDAN PKWY, SUITE 101, SOUTH JORDAN, UT 84095-4652
(801) 446-8007
(801) 676-1030
Mailing address
1268 W SOUTH JORDAN PKWY, SUITE 101, SOUTH JORDAN, UT 84095-4652
(801) 446-8007
(801) 676-1030
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9246474
UT
1223P0221X
Pediatric Dentistry
D-4480-PD
ID
Other
Enumeration date
04/25/2011
Last updated
02/10/2016
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