| NPI | 1720739451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRIS POOLE President 435-753-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |