Individual
FERNANDO FITTIPALDI PESSOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
949 PIONEER RD, A-2, DRAPER, UT 84020-8200
(801) 921-9239
Mailing address
949 PIONEER RD, A-2, DRAPER, UT 84020-8200
(801) 921-9239
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7391760
UT
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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