| NPI | 1851812085 |
|---|---|
| Doing Business As | PANQUITCH DENTAL |
| Entity Type | Organization |
| Authorized Contact | EVAN CHRISTENSEN CEO 435-425-1102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2021-04-21 |