| NPI | 1124554811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGAN ANDERSEN Office Mananger 801-444-9911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 361876) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |