| NPI | 1922211523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY JEAN FRYER Office Manager 435-792-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 285140-9923) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |