| NPI | 1114434636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GEORGE FOSTER Dr/Owner 435-752-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: UT 145420) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |