Individual
KYLE SANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7321 BALMER ST, HILL AFB, UT 84056-5012
(017) 777-0118
Mailing address
7321 BALMER ST, HILL AFB, UT 84056-5012
(807) 777-7011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10391052-9922
UT
Other
Enumeration date
06/14/2017
Last updated
08/11/2021
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