| NPI | 1568827202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASE PEERY Owner 801-969-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 135611-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 130519-9922) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 7579613-9923) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 317724-9922) | |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2016-03-23 |