| NPI | 1346711199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE RYAN MARSHALL Owner 801-704-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |