| NPI | 1942054648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BINGHAM Financial Coordinator 801-766-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |