| NPI | 1154637825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANS C PETERSEN Owner/Dentist 801-969-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: UT 360305-9923) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2025-03-21 |