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Individual

DR. JAY GLEN SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1037 EAST CLAREMONT DR, BOUNTIFUL, UT 84010
(801) 295-1613
(801) 295-1613
Mailing address
1037 E CLAREMONT DR, BOUNTIFUL, UT 84010
(801) 295-1613
(801) 295-1613

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1300729922
UT

Other

Enumeration date
07/06/2007
Last updated
07/08/2007
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