NPI | 1700315462 |
---|---|
Doing Business As | NELSON & TILLMANN FAMILY DENTISTRY, P.L.L.C. |
Entity Type | Organization |
Authorized Contact | MCLEAN BODDY Office Manager 801-281-8433 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 7579281) |
Enumeration Date | 2017-06-07 |
Last Update Date | 2022-07-21 |