Individual
KIRK H ALLRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D
Contact information
Practice address
3550 HARRISON BLVD, SUITE 2, OGDEN, UT 84403-2081
(801) 393-6200
(801) 394-3303
Mailing address
3550 HARRISON BLVD, SUITE 2, OGDEN, UT 84403-2081
(801) 393-6200
(801) 394-3303
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
141076-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
615985
UNITED CONCORDIA PROVIDER
UT
Enumeration date
07/31/2006
Last updated
07/08/2007
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