| NPI | 1699230672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLIN HARRIS Member 801-901-8789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2024-01-15 |