| NPI | 1427997295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH D EGAN Managing Member / General Dentist 801-547-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2026-03-26 |
| Last Update Date | 2026-03-26 |