Organization
SALT LAKE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL G RUDD DDS (PRESIDIENT)
(801) 487-0758
Entity
Organization
Contact information
Practice address
1955 S 1300 E STE 6, SALT LAKE CITY, UT 84105-3684
(801) 487-0758
(801) 487-0750
Mailing address
1955 S 1300 E STE 6, SALT LAKE CITY, UT 84105-3684
(801) 487-0758
(801) 487-0750
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5328713-9922
UT
Other
Enumeration date
09/19/2008
Last updated
09/19/2008
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