| NPI | 1881744951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SHELTON Office Manager 801-568-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-10-18 |