Individual
DR. GRANT B. CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
4190 HIGHLAND DR, SUITE 112, SALT LAKE CITY, UT 84124-2600
(801) 272-9241
(801) 277-9760
Mailing address
4190 HIGHLAND DR, SUITE 112, SALT LAKE CITY, UT 84124-2600
(801) 272-9241
(801) 277-9760
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
133953
UT
Other
Enumeration date
04/17/2007
Last updated
11/11/2021
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