| NPI | 1881236701 |
|---|---|
| Former Legal Business Name | COMMUNITY DENTAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | LINSEY DELISLE Owner Manager 801-349-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |