| NPI | 1376893370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GENE BILLS CEO 801-277-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 221387029922) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: UT 221387029922) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |