| NPI | 1588964340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN S CAHOON Manager 801-560-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 1399149922) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |