Individual
DR. JEFFREY D. CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1963 E 2700 S, SALT LAKE CITY, UT 84106-4053
(801) 467-4747
Mailing address
1963 E 2700 S, SALT LAKE CITY, UT 84106-4053
(801) 467-4747
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
375457
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519545169007
—
UT
Enumeration date
11/15/2006
Last updated
07/08/2007
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