| NPI | 1851802813 |
|---|---|
| Doing Business As | PROVO DOWNTOWN DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIM CASTANEDA Office Manager 801-373-8791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |