Provider Demographics
NPI:1609082023
Name:ULM, SEAN RICHARD (DMD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:RICHARD
Last Name:ULM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 WEST 600 NORTH
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042
Mailing Address - Country:US
Mailing Address - Phone:801-796-6882
Mailing Address - Fax:801-785-2007
Practice Address - Street 1:389 WEST 600 NORTH
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042
Practice Address - Country:US
Practice Address - Phone:801-796-6882
Practice Address - Fax:801-785-2007
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT36726399221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice