NPI | 1497850309 |
---|---|
Entity Type | Organization |
Authorized Contact | JOE C JEPPSON President 801-356-7701 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 2946929922) |
Enumeration Date | 2006-09-14 |
Last Update Date | 2009-08-11 |