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Individual

MR. SHAWN REED GROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
26 W MAIN ST, HYRUM, UT 84319-1206
(435) 245-5866
(435) 245-5869
Mailing address
26 W MAIN ST, HYRUM, UT 84319-1206
(435) 245-5866
(435) 245-5869

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
973464979922
UT

Other

Enumeration date
07/13/2006
Last updated
07/08/2007
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