| NPI | 1053425918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT G GOUPIOS Owner 801-776-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 2697229922) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 1329799922) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |