| NPI | 1689715898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN J JOHN Office Manager 801-224-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 4766943-9922) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2017-03-23 |