| 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 |