Provider First Line Business Practice Location Address:
108 NORTH 1600 WEST
Provider Second Line Business Practice Location Address:
MAPLETON FAMILY DENTISTRY
Provider Business Practice Location Address City Name:
MAPLETON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-491-6844
Provider Business Practice Location Address Fax Number:
801-491-6044
Provider Enumeration Date:
08/16/2006