Kellan Clark
NPI #1366050296 in West Valley City, Utah
Provider Information
- NPI Number
- 1366050296
- Entity Type
- Individual
- Name
- Kellan Clark
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Enumeration Date
- Jul 16, 2020
- Last Updated
- Jul 16, 2020
Practice Location
- Address
- 2792 S 5600 W
- City
- West Valley City
- State
- Utah
- ZIP Code
- 84120-5590
- Phone
- (801) 204-9889
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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