NPI | 1093513889 |
---|---|
Doing Business As | EASTLAKE ENDODONTICS |
Entity Type | Organization |
Authorized Contact | JONATHAN F RICHARDS Owner 801-779-2700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics |
Enumeration Date | 2025-03-06 |
Last Update Date | 2025-03-06 |