Individual
GRANT MATSUURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26 S 2000 E SUITE 5900, SALT LAKE CITY, UT 84112
(801) 581-8951
Mailing address
5840 S MAJESTIC PINE DR, MURRAY, UT 84107-6552
(801) 580-4470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9291145-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2014
Last updated
07/09/2018
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