| NPI | 1932633948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY SEFCIK Owner 801-372-0439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 201897) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 201897) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2021-08-10 |