| NPI | 1972045656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD TORGESON Dentist 801-262-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 6492935) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |