Dustin Kevin Ellsworth, DDS Valid NPI
Individual provider · General Practice Dentistry · Smithfield, UT
- NPI
- 1689304297
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 12885950-9922 (UT)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2022-06-15
- Last updated
- 2022-06-15
Practice location
291 S Main St Ste C
Smithfield, UT 84335-1902
(435) 760-7823