Individual
KYLE SPACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 S 200 W, RICHMOND, UT 84333-1278
(435) 258-2301
Mailing address
98 W 100 S, SMITHFIELD, UT 84335-1956
(435) 668-6479
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11299320-9922
UT
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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