Individual
DR. MATHEW ROBERT MOURITSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7555 CENTER VIEW CT, WEST JORDAN, UT 84084-1970
(801) 562-0115
Mailing address
2663 BRIDLE OAK DR, SOUTH JORDAN, UT 84095-3491
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
265130
UT
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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