Individual
DYLAN LANE HARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1445 N 400 E # 3A, NORTH LOGAN, UT 84341-7564
(435) 363-3595
Mailing address
1750 N 1780 E, NORTH LOGAN, UT 84341-2192
(435) 890-0379
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11769010-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11769010-8903
UTAH DOPL
UT
01
—
11769010-9922
UTAH DOPL
UT
Enumeration date
07/07/2020
Last updated
07/07/2020
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