| NPI | 1891910972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANN W CHURCH Office Manager 435-864-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 267126) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |