| NPI | 1275665325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER KAY WARREN Pres Sec 801-278-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 1404979923) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |