| NPI | 1982107306 |
|---|---|
| Former Legal Business Name | DR. GRANT A. BROUGH, DDS, PC |
| Former Legal Business Name | GRANT A BROUGH, DDS, PC |
| Entity Type | Organization |
| Authorized Contact | GRANT ATWOOD BROUGH Owner/Operator 801-773-5285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 275232) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-06-16 |