| NPI | 1689082059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERD ERICKSON Dentist 435-673-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 133468-8903) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |