Organization
STEPHEN H BENNETT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN BENNETT MD (OWNER)
(801) 266-4212
Entity
Organization
Contact information
Practice address
1045 E 3900 S STE 201, SALT LAKE CITY, UT 84124-1192
(801) 266-4212
Mailing address
1045 E 3900 S STE 201, SALT LAKE CITY, UT 84124-1192
(801) 266-4212
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
161245-1205
UT
Other
Enumeration date
03/10/2011
Last updated
06/25/2012
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