| NPI | 1225446263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH S MAIO Dentist/CEO 801-748-0379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 341237) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2014-07-22 |