Organization
BRYAN E GOTTFREDSON DDS
Active
Other names
Main Street Dental of Magna
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN ELDEN GOTTFREDSON DDS (DENTIST/ OWNER)
(801) 250-7311
Entity
Organization
Contact information
Practice address
9010 W 2700 S, MAGNA, UT 84044-1002
(801) 250-7311
(801) 250-3801
Mailing address
9010 W 2700 S, MAGNA, UT 84044-1002
(801) 250-7311
(801) 250-3801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
360010-9922
UT
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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