| NPI | 1831421155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN D PACKARD Dentist 801-985-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 2948359922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 72615429921) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |