| NPI | 1457476376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT D HACK Owner 801-785-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 56928280160) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2017-03-10 |