| NPI | 1912452558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT T PETERSON Orthodontist 801-710-2226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D009577) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |