Individual
DR. KENNETH CRAIG MAUGHAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
167 N 400 W, SUITE A4, OREM, UT 84057-1909
(801) 226-3302
(801) 226-3535
Mailing address
167 N 400 W, SUITE A4, OREM, UT 84057-1909
(801) 226-3302
(801) 226-3535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5328215
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42-158147
TIN NUMBER
UT
Enumeration date
10/02/2006
Last updated
07/08/2007
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