| NPI | 1144767203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY SEFCIK Official 801-400-4560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 00202298) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |