Individual
TYRA NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1450 W 820 N, PROVO, UT 84601-1305
(801) 818-8917
Mailing address
2158 E BALD EAGLE CT, DRAPER, UT 84020-5714
(435) 757-9717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6277669
UT
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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