| NPI | 1972542801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE J O'DONOGHUE Owner 801-969-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 3252009922) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |