Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 5896661-1205 | UT |
NPI | 1114978533 |
---|---|
Provider Name | Dr. Richard Andrew Dal Canto |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84102-2310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 05/12/2012 |