| NPI | 1942657960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LARSEN Owner 801-295-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 5332372-9922) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |