| NPI | 1710226436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP CLARK HALL Dentist 435-634-8338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: UT 136561) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2018-12-12 |