Individual
MARK J MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD PC
Contact information
Practice address
6070 SOUTH 1300 EAST, SUITE 202, SALT LAKE CITY, UT 84121-6724
(801) 266-2662
(801) 268-2009
Mailing address
6070 SOUTH 1300 EAST, SUITE 202, SALT LAKE CITY, UT 84121-6724
(801) 266-2662
(801) 268-2009
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
137504
UT
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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