| NPI | 1346536653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE LOWRY Office Manager 801-424-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 142369) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2011-06-24 |