| NPI | 1922308618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY L DAVILA Office Manager 801-955-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 5247754) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |