Individual
MCKINSEE BRODERICK WEYHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2114 S HIGHLAND DR, SALT LAKE CITY, UT 84106-2807
(385) 399-0537
(801) 880-8835
Mailing address
2114 S HIGHLAND DR, SALT LAKE CITY, UT 84106-2807
(385) 399-0537
(801) 880-8835
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1361
AK
122300000X
Dentist
59546
CA
122300000X
Dentist
Primary
8088273-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1361
DENTAL LICENSE
AK
01
—
59546
DENTAL LICENSE
CA
01
—
8088273-9922
UTAH DENTAL LICENSE
UT
Enumeration date
08/23/2010
Last updated
12/31/2016
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