Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 143344 | UT |
NPI | 1518185164 |
---|---|
Provider Name | Dr. Dean Crispin Troili |
First Address | Roy, UT 84067 |
Second Address | Ogden, UT 84401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |