| NPI | 1275899809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMA NAY Manager 801-269-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: UT 6216924-9924) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |