| NPI | 1639244387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BLAMIRES Owner 801-547-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 309191-9922) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: UT 361602-9923) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |