JUAN DIAZ DE LEON

PROVO, UT
NPI1093206112
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: UT  8743606-9922)
Enumeration Date2018-05-24
Last Update Date2018-05-24
Business Address
JUAN DIAZ DE LEON DDS
2520 N UNIVERSITY AVE STE 101
PROVO, UT 84604-6081
Phone number: 801-426-6255
Mailing Address
JUAN DIAZ DE LEON DDS
7101 N MOUNTAIN FIELD DR
EAGLE MOUNTAIN, UT 84005-6551
Phone number: