Individual
KIM JAMES MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1480 N 8000 W, SALT LAKE CITY, UT 84116-3961
(801) 522-7135
Mailing address
1480 N 8000 W, SALT LAKE CITY, UT 84116-3961
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
143483-9923
UT
Other
Enumeration date
07/22/2006
Last updated
06/26/2023
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