Individual
BRYAN GLEN TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 587-6189
(801) 585-6485
Mailing address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 587-6189
(801) 585-6485
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
9021109-9921
UT
Other
Enumeration date
05/11/2012
Last updated
12/20/2021
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