| NPI | 1639550585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CHARLES OLSON President 801-486-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 9286307) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |