| NPI | 1669178786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLOAN ROBISON Owner 801-300-5067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-02-02 |