Organization
KELLY D. CARROLL D.D.S., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HICKEN (OFFICE MANAGER)
(801) 943-2020
Entity
Organization
Contact information
Practice address
2114 E FORT UNION BLVD, SALT LAKE CITY, UT 84121-3142
(801) 943-2020
(801) 943-3394
Mailing address
2114 E FORT UNION BLVD, SALT LAKE CITY, UT 84121-3142
(801) 943-2020
(801) 943-3394
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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