| NPI | 1558714550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MAGNESS Manager 801-310-1916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 4936951) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |