| NPI | 1194123463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW J HAMMONS President 435-628-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 6614831) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |