| NPI | 1811057995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY B ELISON President 801-446-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |