| NPI | 1336951292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CHRISTENSEN Owner 801-865-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |