Organization
MCDONOUGH ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROY MCDONOUGH DDS, MSD (OWNER)
(801) 266-2662
Entity
Organization
Contact information
Practice address
6070 S 1300 E, SUITE 202, SALT LAKE CITY, UT 84121-6722
(801) 266-2662
(801) 268-2009
Mailing address
6070 S 1300 E, SUITE 202, SALT LAKE CITY, UT 84121-6722
(801) 266-2662
(801) 268-2009
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6740566-9922
UT
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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