| NPI | 1104955236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BAIRD President 801-967-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: UT 3473289921) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |