| NPI | 1194551804 |
|---|---|
| Doing Business As | BROOKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | DAVID BROOKS Member 801-550-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-12 |