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1497318190
SPENCER BLAKE NIELSEN
SALT LAKE CITY, UT
NPI
1497318190
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-04-17
Last Update Date
2019-04-17
Business Address
SPENCER BLAKE NIELSEN DDS
50 N MEDICAL DR
SALT LAKE CITY, UT 84132-0001
Phone number: 801-587-6453
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Mailing Address
SPENCER BLAKE NIELSEN DDS
530 S WAKARA WAY
SALT LAKE CITY, UT 84108-1299
Phone number:
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