Individual
KENT WILSON BROADBENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
2511 E 2750 N, LAYTON, UT 84040-8179
(801) 771-0259
Mailing address
2511 E 2750 N, LAYTON, UT 84040-8179
(801) 771-0259
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
73-135296-9921
UT
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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