Individual
DR. BRYCE FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2441 21ST ST, USA DENTAL ACTIVITY, FORT CAMPBELL, KY 42223-5582
(270) 798-8614
Mailing address
120 W. 1250 N. SUITE 200, LOGAN, UT 84341
(435) 753-7563
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00202283
CO
1223G0001X
General Practice Dentistry
Primary
11105993-9922
UT
Other
Enumeration date
08/19/2014
Last updated
06/13/2019
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