| NPI | 1184706491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R. ANDERSON Owner 801-540-5081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 341292) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-12-20 |