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 |