| NPI | 1851538862 |
|---|---|
| Other Name | SLDDS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M. JENSEN Executive Director 801-983-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-01-16 |