Individual
CHAD ALDEN GUNNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1320 N 600 E STE 2, LOGAN, UT 84341-2474
(435) 752-1747
Mailing address
2908 W 5700 S, WELLSVILLE, UT 84339-9767
(143) 599-4464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
123263609922
UT
1223G0001X
General Practice Dentistry
123263699922
UT
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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