Individual
D. JOHN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
325 W CENTER STREET, SPANISH FORK, UT 84660
(801) 798-7301
(801) 798-8513
Mailing address
325 W CENTER STREET, SPANISH FORK, UT 84660
(801) 798-7301
(801) 798-8513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
187592-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0463
—
UT
Enumeration date
09/01/2006
Last updated
07/08/2007
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