| NPI | 1235568015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN B DAVIDSON Owner 801-825-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 5319871) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |