M Kelly Soutas Dmd PC

NPI #1316315369 in Springville, Utah

Provider Information

NPI Number: 1316315369
Entity Type: Organization
Organization Name: M Kelly Soutas Dmd PC
Primary Specialty: Dentist
Enumeration Date: Sep 8, 2015
Last Updated: Sep 8, 2015

Practice Location

Address: 485 S MAIN ST
Address 2: STE 302
City: Springville
State: Utah
ZIP Code: 84663-2279
Phone: (801) 489-6811

Authorized Official

Name: DR. MICHAEL KELLY SOUTAS, DMD
Title: PRESIDENT
Phone: (801) 489-6811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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