NPI | 1205057197 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN K JENSEN Owner 801-553-1616 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 145786) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2020-08-22 |