NPI | 1154744399 |
---|---|
Former Legal Business Name | PROGRESSIVE DENTAL |
Entity Type | Organization |
Authorized Contact | JASON G BARTON Member/Owner 801-544-3953 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: UT 5310263) |
Enumeration Date | 2014-01-23 |
Last Update Date | 2014-01-23 |