| NPI | 1609372903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON D CASTO Member/Owner 801-870-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 144139) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-03-26 |