| NPI | 1316385206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DANIEL FELLER President 801-318-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE.60372518) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-12 |