Organization
JON CHISHOLM DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON CHISHOLM (OWNER)
(801) 754-0678
Entity
Organization
Contact information
Practice address
10 S 300 W, SANTAQUIN, UT 84655-8147
(801) 754-0678
(801) 754-1157
Mailing address
10 S 300 W, SANTAQUIN, UT 84655-8147
(801) 754-0678
(801) 754-1157
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
97-341982-9921
UT
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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