| NPI | 1083298525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA SHIGLEY Office Manager 801-450-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2023-09-08 |