Individual
JUAN CAMILO REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
49 W CENTER ST, MIDVALE, UT 84047-7364
(385) 887-9002
Mailing address
650 W SOUTH TEMPLE APT C108, SALT LAKE CITY, UT 84104-1041
(918) 907-1335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12322159-9923
UT
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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