| NPI | 1013367036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER LANDON BYE Owner/Partner 801-364-7943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 5673900) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: UT 7991108) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |