Mark Jardine, DDS Valid NPI
Individual provider · General Practice Dentistry · Provo, UT
- NPI
- 1801177704
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 8544722-9921 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2011-09-06
- Last updated
- 2024-03-17
Practice location
3330 N University Ave Ste A
Provo, UT 84604-4454
(801) 615-2917