| NPI | 1639401532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE A PEERS Owner 435-615-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 98362987) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-03-16 |