| NPI | 1063713444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KENT HANSEN Owner/Dentist 801-423-0905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 6598211) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |