| NPI | 1356879720 |
|---|---|
| Doing Business As | CRYSTAL CANYON FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | KEVEN FREEMAN Owner 801-520-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D-4834) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2017-05-30 |