| NPI | 1851472658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD K JOLLEY Co Presidents 435-789-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 1373389922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 1393669922) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |