Faddis, Kelly A
Faddis, Kelly A is an sole proprietor health care provider with primary practice located at 11760 S 700 E #110, Draper UT 84020-6604. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Faddis, Kelly A can be contacted via phone (801) 571-6688.Contact Information
Primary practice address
11760 S 700 E #110
Draper UT 84020-6604
Phone: (801) 571-6688
Fax: (801) 571-7787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 144920-9922 | Utah |
Profile Details
| NPI number | 1003858432 |
|---|---|
| LBN Legal business name | Faddis, Kelly A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2006 |
| Last updated | May 31st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003858432 | NPPES |
| Utah | Other | 87-0581297 | FEDERAL ID # |
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