Whalio Doctors

NPI 1003962960

Kelly D Carroll, DDS

Practitioner General Practice Dentistry Salt Lake City, UT

Practice location

Address
2114 Fort Union Blvd, Salt Lake City, UT 84121
Phone
(801) 943-2020
Mailing address
4023 E Prospector Dr, Slc, UT 84121

Registered specialties

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence 3251999922 (UT)

Registry record

NPI
1003962960
Entity type
Individual
Sex (as registered)
Male
NPI issued
25 Jan 2007
Record last updated
2 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.