| NPI | 1164181293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MCDONOUGH Doctor/Owner 801-541-8223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-16 |