| NPI | 1831339829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CREED S HAYMOND Owner 801-576-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: UT 145378) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2009-03-06 |