Individual
CRAIG D FACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
395 S 100 W, CEDAR CITY, UT 84720-3379
(435) 586-3849
Mailing address
395 S 100 W, PO BOX 489, CEDAR CITY, UT 84720-3379
(435) 586-3849
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
143601-9922
UT
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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