| NPI | 1760995526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN JAY ORVIN Owner 801-989-7803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 8813690-9922) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2018-03-17 |