| NPI | 1821400532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED MATHEW BROWN Owner/Surgeon 801-938-3412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: UT 355097-9924) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |