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230 S Main St Ste B Tooele UT 84074-2744 | |
| (435) 882-2755 | |
| (435) 882-0301 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 230 S Main St Ste B, Tooele, Utah |
| Authorized Official Name and Position | Shannon D Lawson (DENTIST) |
| Authorized Official Contact | 4358401040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
230 S Main St Ste B Tooele UT 84074-2744 Ph: (435) 882-2755 | 230 S Main St Ste B Tooele UT 84074-2744 Ph: (435) 882-2755 |
| NPI Number | 1760251664 |
|---|---|
| Provider Enumeration Date | 12/20/2023 |
| Last Update Date | 12/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760251664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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