Individual
DALLYN PORTER UDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200-250, GILBERT, AZ 85234-2168
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
011544
AZ
207X00000X
Orthopaedic Surgery Physician
20A19340
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
011544
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
20A19340
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2019
Last updated
05/02/2025
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