Individual
HYRUM KENNETH MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
51ST MEDICAL GROUP, UNIT 2060, APO AP, UT 96266-2060
(801) 931-9154
Mailing address
5855 E STILL CIR, MESA, AZ 85206-3631
(480) 248-8100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11767177-9922
UT
Other
Enumeration date
03/02/2020
Last updated
11/04/2025
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