Healthcare Provider Details

I. General information

NPI: 1639306889
Provider Name (Legal Business Name): DANIEL L PREECE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N 400 W
SALT LAKE CITY UT
84103-1229
US

IV. Provider business mailing address

430 N 400 W
SALT LAKE CITY UT
84103-1229
US

V. Phone/Fax

Practice location:
  • Phone: 801-532-1822
  • Fax: 801-532-7544
Mailing address:
  • Phone: 801-532-1822
  • Fax: 801-532-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number7720998 0501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: