| NPI | 1710304654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN MENLOVE President 801-448-2346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 6361) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |