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1477693802
BLAKE LYNN MATTHEWS
PROVO, UT
NPI
1477693802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: UT 222754989922)
Enumeration Date
2007-02-07
Last Update Date
2007-07-08
Business Address
-- BLAKE LYNN MATTHEWS DDS
3610 N UNIVERSITY AVE #200
PROVO, UT 84604-4437
Phone number: 801-377-9600
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Mailing Address
-- BLAKE LYNN MATTHEWS DDS
3540 NORTH 465 WEST
PROVO, UT 84601
Phone number:
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