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Individual

THEODORE ROBERT SMALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
30 W MEDICAL DR, MONUMENT VALLEY, UT 84536-7705
(435) 727-3004
Mailing address
30 W MEDICAL DR, MONUMENT VALLEY, UT 84536-7705
(510) 239-3172

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
140487-9922
UT
122300000X
Dentist
Primary
140487-9926
UT

Other

Enumeration date
01/22/2016
Last updated
02/03/2026
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