| NPI | 1952143802 |
|---|---|
| Doing Business As | GEM STATE SMILES |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SCOTT MADSEN Practice Owner 801-455-9233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |