| NPI | 1114324456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN T MATSUMORI Owner/Dentist 801-571-8391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: UT 7987460-9921) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |