NPI | 1134523459 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD K JOLLEY Co Owner 435-789-2888 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 137338) |
Enumeration Date | 2014-10-15 |
Last Update Date | 2014-10-15 |