Individual
KELLY A MANGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7110 HIGHLAND DR, COTTONWOOD HEIGHTS, UT 84121-3704
(801) 943-6880
(801) 943-4744
Mailing address
7L110 SOUTH HIGHLAND DRIVE, COTTONWOOD HEIGHTS, UT 84121
(801) 943-6880
(801) 943-4744
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2663
UT
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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