Individual
DR. GLEN LYNN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
PO BOX 510721, SALT LAKE CITY, UT 84151-0721
(801) 587-6872
(801) 587-6675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
131858-9921
UT
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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