| NPI | 1205115193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARON E LARSEN General Dentist 801-756-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 4748626) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |