| NPI | 1730506809 |
|---|---|
| Doing Business As | DENTAL DEPOT |
| Entity Type | Organization |
| Authorized Contact | BRADY SEFCIK Dds/Owner 801-400-4560 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 00202298) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00201897) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2016-02-29 |