| NPI | 1467087320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN MATTHEW KENLEY Doctor 435-757-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |