NPI | 1225249683 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID C ROTH Owner 801-446-1515 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: UT 343291) |
Additional Taxonomies | 122300000X Dentist (Licence: UT 5667938) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2020-08-22 |