| NPI | 1093838377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER ROBERT ALBRECHT President 435-586-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: UT 63359359921) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |