| NPI | 1205286655 |
|---|---|
| Other Name | TILLMANN DENTAL |
| Entity Type | Organization |
| Authorized Contact | MCLEAN BODDY Office Manager 801-281-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 7393738) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |