NPI | 1770001612 |
---|---|
Doing Business As | BURG CHILDREN'S DENTISTRY & ORTHODONTICS-ORCHARD DRIVE |
Entity Type | Organization |
Authorized Contact | MARCI NICOL COO 801-312-7122 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
Enumeration Date | 2017-08-30 |
Last Update Date | 2017-08-30 |