| NPI | 1679823058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R COTTAM Dentist 801-261-3178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: 8296939-9923) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |