Individual
DR. SPENCER SONNTAG BLACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
4585 SILVER SPRINGS DR, PARK CITY, UT 84098-5913
(435) 649-0099
Mailing address
3097 E HIGH DANISH RD, SANDY, UT 84093-5510
(847) 907-1989
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
7894995-9921
UT
Other
Enumeration date
10/05/2020
Last updated
06/14/2022
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