| NPI | 1558663120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANS CHRISTIAN PETERSEN Dr. 801-766-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 5323980-9922) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |