Individual
DR. CARTER TIMOTHY BRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 631-5779
Mailing address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 215-9617
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12317468-9923
UT
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
12317468-9923
UT
Other
Enumeration date
03/23/2021
Last updated
03/09/2025
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