NPI | 1902007354 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY K. CLARK President 801-572-1130 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 141551-9922) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2020-08-22 |