| NPI | 1356081624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER WILLIAMS Owner 801-901-8990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2023-06-01 |