Individual
JEREMY BRUCE MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8846 S REDWOOD RD STE N201, WEST JORDAN, UT 84088-4702
(801) 566-0631
Mailing address
8846 S REDWOOD RD STE N201, WEST JORDAN, UT 84088-4702
(801) 566-0631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9823805-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
UT
Other
Enumeration date
05/03/2016
Last updated
02/24/2021
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