NPI | 1023143088 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY J. OLSEN Doctor Of Dental Surgery 435-628-5496 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 309573-9923) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2020-08-22 |