| NPI | 1598564080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA MAUGHAN Owner/Manager 801-318-8520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-10 |