| NPI | 1962355222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY BRANDON KEHL Managing Member 801-560-6408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2026-02-17 |
| Last Update Date | 2026-02-18 |