| NPI | 1154849081 |
|---|---|
| Doing Business As | BURG CHILDREN'S DENTISTRY & ORTHODONTICS- VINE STREET |
| Entity Type | Organization |
| Authorized Contact | MARCI NICOL COO 801-312-1722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |