| NPI | 1922501626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY FORD HUFFAKER President 801-292-5172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 10411720-9922) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |