| NPI | 1144829946 |
|---|---|
| Other Name | MOUNTAINLANDS COMMUNITY HEALTH CENTER - PROVO DENTAL |
| Entity Type | Organization |
| Authorized Contact | ERIC JOHNSON Financial Director 801-855-0091 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2021-03-25 |