| NPI | 1619826864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINSEY GROESBECK Office Manager 435-755-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2026-01-22 |
| Last Update Date | 2026-01-22 |