| NPI | 1629087366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GLEN MCMILLAN President 801-546-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 5709259) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |