Individual
DR. MICHELLE KRISTIN MAAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6268 S 900 E, STE 100, SALT LAKE CITY, UT 84121-2497
(801) 566-5117
Mailing address
6268 S 900 E, STE 100, SALT LAKE CITY, UT 84121-2497
(801) 566-5117
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
054597
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7372659-9924
LICENSE
UT
Enumeration date
08/23/2009
Last updated
06/11/2019
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