| NPI | 1255407011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WARD SPENDLOVE President 435-789-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 139801-9922) |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2020-08-22 |