| NPI | 1013261007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW SCHWEPPE Owner 801-479-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 1432269923) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |