| NPI | 1093713554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BENSON Owner 801-614-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: UT 4124) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-08-22 |