| NPI | 1336548841 |
|---|---|
| Doing Business As | OUT OF THIS WORLD DENTISTRY WJ |
| Entity Type | Organization |
| Authorized Contact | DANNIELLE STARK Office Manager 801-898-7502 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 144937) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2014-08-20 |