| NPI | 1427840297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL D DUCKWORTH Owner 801-718-6395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |