| NPI | 1629119409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN J. JOHN Office Manager 801-756-7173 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 4766943-9922) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2017-03-24 |