Individual
JACKIE IMLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
321 N MALL DR STE P101, ST GEORGE, UT 84790-7338
(435) 673-4809
(435) 628-5939
Mailing address
321 N MALL DR STE P101, ST GEORGE, UT 84790-7338
(435) 673-4809
(435) 628-5939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00035640
UT
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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