Healthcare Provider Details

I. General information

NPI: 1942542758
Provider Name (Legal Business Name): DENNIS C. LAW DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W 7200 S
MIDVALE UT
84047-1041
US

IV. Provider business mailing address

308 W 7200 S
MIDVALE UT
84047-1041
US

V. Phone/Fax

Practice location:
  • Phone: 801-631-5844
  • Fax:
Mailing address:
  • Phone: 801-631-5844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number113690-2801
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: