| NPI | 1912014234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE BREEZE Office Manager 801-886-9341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 143681-9922) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |