Individual
JESSICA BIRRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDT
Contact information
Practice address
11978 S 700 E STE 101, DRAPER, UT 84020-9818
(801) 352-7002
(801) 769-1246
Mailing address
11978 S 700 E STE 101, DRAPER, UT 84020-9818
(801) 352-7002
(801) 769-1246
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
223233500
UT
126900000X
Dental Laboratory Technician
223233500
UT
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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