| NPI | 1962162412 |
|---|---|
| Doing Business As | WASATCH PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | DANIEL THUNELL Member 801-783-6249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2021-12-26 |
| Last Update Date | 2021-12-26 |