| NPI | 1356607493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT PACKHAM Owner/Dentist 801-799-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 6362621-9922) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2013-07-17 |