Individual
DR. JON RALPH CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
10 S 300 W, SANTAQUIN, UT 84655-8147
(801) 754-0678
(801) 754-1157
Mailing address
10 S 300 W, P.O BOX 266, SANTAQUIN, UT 84655-8147
(801) 754-0678
(801) 754-1157
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
973419729921
UT
Other
Enumeration date
12/01/2006
Last updated
08/03/2010
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