| NPI | 1912274051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARNEY TODD OLSEN Dentist/Owner 801-562-5505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 76505) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 76505) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-17 |