| NPI | 1982142824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BABCOCK Dentist 801-254-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: UT 5483941) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |