| NPI | 1477892685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN BRAITHWAITE Owner 801-763-7737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 5070492-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 5148371-9922) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2013-02-07 |