| NPI | 1518040591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE GALE Asst. Office Manager 801-375-4707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-05-13 |