| NPI | 1235601659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LEE BECKSTROM Orthodontist, Owner 435-628-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-12-24 |
| Last Update Date | 2018-12-24 |