| NPI | 1427278019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESTER W CANNON Owner 801-277-4049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 1364589922) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2012-04-12 |