| NPI | 1245352285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY THOMAS REESE President 435-882-0685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 129932-9922) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |