| NPI | 1750527826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES W ELLIS Dentist 801-394-4519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 5664249) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2014-08-27 |