| NPI | 1346458932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN C LIDDELL Partner 801-733-0406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 512081-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 22-13695-9922) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2008-02-26 |