| NPI | 1518186188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LEE NEWEY Owner 801-825-1116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: UT 280152) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |