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General NPI Number Information
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NPI Number | 1629085923
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Entity Type | Individual
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Provider Name | ALAN DREW MEILSTRUP DDS
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1409 W 1000 N
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-1605
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Country | US
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Telephone | 801-595-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 E 125 S
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City | LAYTON
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State | UT
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Zip | 84040-3166
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Country | US
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Telephone | 801-547-0262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 137750
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License Number State | UT
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