Individual
BRAD C THEURER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1340 N 600 E STE 1, LOGAN, UT 84341-2475
(435) 752-2230
Mailing address
531 S 1080 E, SMITHFIELD, UT 84335
(435) 760-9258
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10842216-9922
UT
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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