| NPI | 1447634324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAELOR JEPPSON Insurance COO Rdinator 801-305-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 7366264-9922) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |