| NPI | 1932806528 |
|---|---|
| Doing Business As | BACK OF THE WASATCH |
| Entity Type | Organization |
| Authorized Contact | KAYLA SHADE Revenue Cycle Manager 801-305-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-02-14 |