| NPI | 1649016122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA STOKER Orthodontist 801-560-3702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |