| NPI | 1619278785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BUTLER Office Manager 801-562-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 5247754) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |