| NPI | 1316169162 |
|---|---|
| Doing Business As | SIGNATURE SMILES LUXURY DENTAL SPA |
| Entity Type | Organization |
| Authorized Contact | KEITH VICTOR NELSON President 801-968-9147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 5032263) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 62277) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2013-07-17 |