| NPI | 1609362094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA CAROL PALMER Office Manager 801-399-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 143920) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |