Bruce H Godderidge, DMD Valid NPI
Individual provider · Dentist · Smithfield, UT
- NPI
- 1053436816
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 1431759922 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2007-03-20
- Last updated
- 2007-07-08
Practice location
291 South Main, Suite A
Smithfield, UT 84335
(435) 563-6213