KELLY A FADDIS

DRAPER, UT
NPI1003858432
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: UT  144920-9922)
Enumeration Date2006-06-11
Last Update Date2011-05-31
Business Address
Dr. KELLY A FADDIS dds
11760 S 700 E #110
DRAPER, UT 84020-6604
Phone number: 801-571-6688
Mailing Address
Dr. KELLY A FADDIS dds
11760 S 700 E #110
DRAPER, UT 84020-6604
Phone number: 801-571-6688
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