Individual
MICHAEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4775 W DAYBREAK PKWY STE 201, SOUTH JORDAN, UT 84009-5140
(801) 280-1911
Mailing address
1838 N 1500 E, PROVO, UT 84604-5750
(909) 631-6501
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11276187-9922
UT
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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