| NPI | 1942065487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LANGLEY Billing Manager 801-438-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-02-19 |