| NPI | 1497541437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUREAN TRAVAS SMITH Manager/CEO 801-310-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-04-16 |