| NPI | 1033497417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S WILKINSON Owner 435-752-5681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 1396909924) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 79545799924) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2025-02-24 |