Provider Demographics
NPI:1538729256
Name:SALMON, NATHAN DAHL (DDS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DAHL
Last Name:SALMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E 600 S STE 1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3922
Mailing Address - Country:US
Mailing Address - Phone:435-656-3868
Mailing Address - Fax:
Practice Address - Street 1:350 E 600 S STE 1
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3922
Practice Address - Country:US
Practice Address - Phone:435-656-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11338406-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice