NPI | 1679182612 |
---|---|
Doing Business As | COPPER MOUNTAIN DENTAL |
Entity Type | Organization |
Authorized Contact | TREVOR ROSS LINDGREN Principal Owner (CEO) 801-440-5520 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-07-27 |
Last Update Date | 2020-07-27 |