| NPI | 1588039499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BOYCE MATTHEWS Owner / Provider 801-766-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: UT 5142959) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |