Organization
PACKARD DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D PACKARD D.M.D (DENTIST)
(801) 985-3300
Entity
Organization
Contact information
Practice address
3505 W 4800 S, ROY, UT 84067-9461
(801) 985-3300
(801) 985-3301
Mailing address
3505 W 4800 S, ROY, UT 84067
(801) 985-3300
(801) 985-3301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2948359922
UT
1223G0001X
General Practice Dentistry
72615429921
UT
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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