| NPI | 1003143413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATE LOTT VIEHWEG Owner 801-766-4834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 6632857) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2020-10-23 |