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General NPI Number Information
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NPI Number | 1629254552
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Entity Type | Individual
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Provider Name | TRENTON DAYLE THALMAN DDS MSD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 130 E 600 N
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City | RICHFIELD
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State | UT
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Zip | 84701
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Country | US
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Telephone | 435-893-9900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 246
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City | RICHFIELD
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State | UT
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Zip | 84701-0246
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Country | US
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Telephone | 435-893-9900
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3085994-9921
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License Number State | UT
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