| NPI | 1407085160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI JEWKES Office Manager 801-614-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 5889917) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |