Kelly A Faddis DDS

NPI 1003858432 - Dentist - 1223G0001X

NPI Details
NPI 1003858432
Gender Male
Enumeration Date 06/11/2006
Last Updated 05/31/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
11760 S 700 E
#110
DRAPER UT, 84020-6604, US
Phone (801) 571-6688
Fax (801) 571-7787
Business Location
11760 S 700 E
#110
DRAPER UT, 84020-6604, US
Phone (801) 571-6688
Fax (801) 571-7787
Toxanomy
Taxonomy Code 1223G0001X
License State Utah
License Number 144920-9922
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According to our database, Dr. Kelly A Faddis DDS NPI is 1003858432, taxonomy code is 1223G0001X and license number is 144920-9922, license state is located at Utah. Kelly A Faddis DDS physically located at 11760 S 700 E, Draper UT, 84020-6604. NPI Number Kelly A Faddis DDS has the Individual type.

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1003858432 NPI number is provided on an as is basis without warranty of any kind. 1003858432 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly A Faddis DDS are for informational purposes only.