| NPI | 1376096966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ODION Owner 801-877-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 8858650) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |