Organization
CHISHOLM FAMILY DENTISTRY INC
Active
Other names
Richard T Chilsholm DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD T CHILSHOLM DDS (DENTIST OWNER)
(435) 527-3555
Entity
Organization
Contact information
Practice address
30 S MAIN ST, MONROE, UT 84754
(435) 527-3555
(435) 527-3618
Mailing address
PO BOX 69, 30 S MAIN ST, MONROE, UT 84754
(435) 527-3555
(435) 527-3618
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3241439921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528376111001
—
UT
Enumeration date
12/05/2006
Last updated
08/22/2020
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