Individual
DR. THOMAS AUSTEN BROADBENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3540 S 4000 W, SUITE #140, WEST VALLEY, UT 84120-3260
(801) 969-6200
Mailing address
3540 S 4000 W, SUITE #140, WEST VALLEY, UT 84120-3260
(801) 969-6200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7390228-9922
UT
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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