| NPI | 1174012876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GARNER Director Of Operations 801-614-7669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |