| NPI | 1700167095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARISON DAN COUSER Owner 801-544-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 6698874) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |