NPI | 1528385085 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY B ELISON President 435-579-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2010-04-23 |
Last Update Date | 2010-04-23 |