Individual
DR. JONATHAN DAVID PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3505 W 4800 S, ROY, UT 84067-9461
(801) 985-3300
(801) 985-3301
Mailing address
4690 S 4650 W, WEST HAVEN, UT 84401-9301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
294835-9922
UT
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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