| NPI | 1750679577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JAMES SORENSEN Dentist/Owner 801-798-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: UT 133126) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-07-13 |