Individual
MARK D. MCKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
777 N 500 W, # 204, PROVO, UT 84601-1541
(801) 374-2182
(801) 374-0130
Mailing address
777 N 500 W, # 204, PROVO, UT 84601-1541
(801) 374-2182
(801) 374-0130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
144960-9921
UT
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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