| NPI | 1811396260 |
|---|---|
| Doing Business As | OUT OF THIS WORLD SJ |
| Entity Type | Organization |
| Authorized Contact | CORY STARK Owner 801-260-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2022-07-21 |