| NPI | 1457767840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY JACK SCHOLZEN Doctor / Owner 435-586-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 6329558-9923) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |