Healthcare Provider Details

I. General information

NPI: 1710301528
Provider Name (Legal Business Name): MARCY ALLISON WELLS ROGERS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCY ALLISON WELLS

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 09/11/2025
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 S NAVAJO ST SUITE C
SALT LAKE CITY UT
84104-3493
US

IV. Provider business mailing address

4745 S 3200 W
TAYLORSVILLE UT
84129-2822
US

V. Phone/Fax

Practice location:
  • Phone: 801-955-2360
  • Fax: 801-982-9232
Mailing address:
  • Phone: 801-858-3461
  • Fax: 801-955-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8892642-9922
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: