| NPI | 1154739787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD BAILEY Executive Director 801-429-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: UT 138432-9922) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2021-03-25 |