| NPI | 1205042686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KENT SCOVILLE Owner 801-776-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 4974568-0160) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |