Ronald J Blackhurst, DDS Valid NPI
Individual provider · General Practice Dentistry · Midvale, UT
- NPI
- 1528108784
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 136235 (UT)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-02-07
- Last updated
- 2007-07-08
Practice location
7001 S 900 E Ste 450
Midvale, UT 84047-6016
(801) 561-5212