| NPI | 1902942451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT F PAGE Dentist 801-292-7807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 53363099922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 1443759922) |
| 124Q00000X Dental Hygienist (Licence: UT 3745519920) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |