| NPI | 1730548397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L NEWEY Owner 801-825-1116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 280752) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-17 |