| NPI | 1497168975 |
|---|---|
| Doing Business As | STONEHAVEN DENTAL - PROVO, LLC |
| Entity Type | Organization |
| Authorized Contact | STEVE JAMES CFO 502-254-8504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |