| NPI | 1033407150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL K MCMILLAN President 801-756-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: UT 142879-9922) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: UT 142879-9922) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2015-06-01 |