| NPI | 1669691945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ALAN BOWMAN President 801-964-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 142830) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |