Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 144299-9921 | UT |
NPI | 1124228168 |
---|---|
Provider Name | Dr. Scott Bryan Hair |
First Address | Salt Lake City, UT 84111-1329 |
Second Address | Salt Lake City, UT 84102-1013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 04/02/2016 |