Individual
PAUL BENJAMIN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, CCA
Contact information
Practice address
1455 S 500 W STE D, BOUNTIFUL, UT 84010-8252
(801) 997-0545
(888) 977-5399
Mailing address
3474 S 100 E, BOUNTIFUL, UT 84010-6605
(801) 997-0545
(888) 977-5399
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
—
—
224P00000X
Prosthetist
—
—
229N00000X
Anaplastologist
Primary
—
—
246ZA2600X
Medical Art Specialist/Technologist
—
—
Other
Enumeration date
04/16/2007
Last updated
10/31/2024
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