| NPI | 1326352071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL MCKAY STUCKI Owner/President 801-636-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 1454049922) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2010-08-04 |