| NPI | 1437991353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENRIOD Manager 801-792-7018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |