Individual
DR. CHAD KELLY BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
589 SOUTH STATE STREET, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Mailing address
589 SOUTH STATE STREET, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6977043-9923
UT
1223G0001X
General Practice Dentistry
6977043
UT
Other
Enumeration date
07/17/2008
Last updated
04/15/2020
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