| NPI | 1235341744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LLOYD V. TILT President 801-394-6651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 1377129922) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |