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Individual

DR. WAYNE R CHISHOLM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
30 SOUTH MAIN STREET, MONROE, UT 84754
(435) 527-3555
(435) 527-3618
Mailing address
PO BOX 69, MONROE, UT 84754-0069
(435) 527-3555
(435) 527-3618

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
134634
UT

Other

Enumeration date
03/18/2008
Last updated
03/18/2008
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