| NPI | 1063736767 |
|---|---|
| Doing Business As | KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | CRAIG L VAN ALFEN Member 801-808-9465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |