| NPI | 1376827832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN JOHN HOPKIN President 801-277-3942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: UT 7752965) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2016-11-14 |