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Individual

DR. STUART DANIEL SEGURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MSD

Contact information

Practice address
275 W 200 N, SUITE 175, LINDON, UT 84042-5009
(801) 769-2530
Mailing address
10211 N 6650 W, HIGHLAND, UT 84003-6726

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7108173-9921
UT
1223P0221X
Pediatric Dentistry
Primary
7108173-9922
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7108173-9921
STATE LICENSE
UT
Enumeration date
09/04/2008
Last updated
04/03/2014
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