Individual
GLEN L MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
70 W GORDON AVE, LAYTON, UT 84041-2569
(801) 546-9400
(801) 546-9431
Mailing address
130 TWIN PEAKS DR, LAYTON, UT 84040-4424
(801) 544-5615
(801) 546-9431
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
138590
UT
Other
Enumeration date
03/17/2006
Last updated
01/05/2009
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