| NPI | 1740386713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER ASHMAN Owmer 801-373-6928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 128884) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 264214) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |