| NPI | 1457850844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DORIUS Part Owner 435-656-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-13 |