| NPI | 1962635466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLI D STEWART Clinic Manager 801-333-8138 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 133186-9922) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |