| NPI | 1063524296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK K. RASMUSSEN President 801-969-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |