| NPI | 1669745477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT DILLEY Owner 801-655-3788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: UT 12604477-003-STC) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |