| NPI | 1982070579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN DAVIDSON Director 801-964-6850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 8644531-9922) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |