Individual
MICHAEL ROY BRONSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1448 N 2000 W, SUITE #6, CLINTON, UT 84015-8377
(801) 728-3924
(801) 728-9109
Mailing address
1987 S 1840 W, SYRACUSE, UT 84075-8549
(801) 710-8774
(801) 728-9109
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5346717-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528564603001
—
UT
Enumeration date
01/24/2006
Last updated
07/08/2007
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