Individual
DR. WELLS S. BROCKBANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
490 N MAIN ST, SPANISH FORK, UT 84660-1440
(801) 798-9874
(801) 798-9630
Mailing address
490 N MAIN ST, SPANISH FORK, UT 84660-1440
(801) 798-9874
(801) 798-9630
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
142412
UT
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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