Individual
CHRISTOPHER MICHAEL FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
5677 S 1475 E STE 2A, SOUTH OGDEN, UT 84403-7003
(801) 479-9800
Mailing address
276 SPENCER WAY UNIT 1, FARMINGTON, UT 84025-3229
(717) 725-2453
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
127399519922
UT
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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