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Individual

LANCE DUSTIN ROBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12473 S MINUTEMAN DR, DRAPER, UT 84020-7870
(801) 495-7900
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 495-7900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8380171-1204
UT

Other

Enumeration date
04/04/2011
Last updated
02/04/2016
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