Individual
MARK SPENCER MCGOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
415 MEDICAL DR, A200, BOUNTIFUL, UT 84010-4946
(801) 203-0290
Mailing address
415 MEDICAL DR, A200, BOUNTIFUL, UT 84010-4946
(801) 203-0290
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
80087979922
UT
Other
Enumeration date
04/16/2011
Last updated
06/28/2016
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