| NPI | 1972783017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK COOK GEDDES Dentist 801-394-4415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 5145132-9922) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |