| NPI | 1114462330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW O JENSEN Dentist/Owner 801-656-7978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D008930) |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2016-12-23 |