| NPI | 1851478572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GLEN KILLIAN General Dentist 435-884-3476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 135097) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |