| NPI | 1891700290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN GRANT INGERSOLL President 801-225-1179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: UT 138355-9922) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-10-27 |