| NPI | 1346398518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL S. BURDETT President 801-475-0680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 293245) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 131585) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2020-08-22 |