| NPI | 1609325091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM NICHOLAS SHEPHERD Partner 801-434-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 370600-9921) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 8012319) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |