| NPI | 1831346527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE VAN LEEUWEN Dentist/Owner 801-943-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 138074) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |