| NPI | 1053442103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT H. CRAVEN President,Dentist 801-546-0931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 1362169922) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |