Individual
BRADLEY ALAN PRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N MEDICAL DR DENTAL CLINIC #E11, SALT LAKE CITY, UT 84132-1213
(801) 581-8951
Mailing address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 587-2191
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/27/2023
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