Kellan Clark
NPI 1366050296 · on the registry since 2020 · sole proprietor
Practice
- Address
- 2792 S 5600 W
West Valley City, UT 84120 - Phone
- (801) 204-9889
- Organisation at this address
- West Shores Surgical Center
Enhance Dental- Hunter Park, Llc
Big Kahuna Dental, Llc Dba Aloha DentalInferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah