Individual
MR. RYAN GEORGE BOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2852 W 4700 S, SUITE A, SALT LAKE CITY, UT 84118-2100
(801) 968-9147
(801) 966-2932
Mailing address
2852 W 4700 S, SUITE A, SALT LAKE CITY, UT 84118-2100
(801) 968-9147
(801) 966-2932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6264440-9922
UT
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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