| NPI | 1669887204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BART WILSON WOLTHUIS Dr. 801-399-5831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 140299) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |