| NPI | 1922440031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE LAMARR CARLSON Owner 435-787-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 1433829922) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-07-18 |