| NPI | 1518838861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CAMPBELL Owner/Operator 801-682-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |