NPI | 1225255946 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID O. LOFTUS President 801-262-7427 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 141902-9921) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2020-08-22 |