| NPI | 1013192731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN JENSEN Owner/President 801-544-4204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 322402-9922) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |