| NPI | 1700821089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDON C. MACKAY President 801-969-3025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 134443) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 5331693) |
| 1223G0001X Dentist, General Practice (Licence: UT 5923241) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |