| NPI | 1316315369 |
|---|---|
| Doing Business As | A PLACE TO SMILE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KELLY SOUTAS President 801-489-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 374892) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |