KELLAN CLARK

WEST VALLEY CITY, UT
NPI1366050296
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: UT  11782184-9922)
Enumeration Date2020-07-16
Last Update Date2020-07-16
Business Address
KELLAN CLARK
2792 S 5600 W
WEST VALLEY CITY, UT 84120-5590
Phone number: 801-204-9889
Mailing Address
KELLAN CLARK
1506 S 900 E
SALT LAKE CITY, UT 84105-2306
Phone number: 406-597-7291