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 |