| NPI | 1992520431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CHRISTENSEN Owner 801-390-1228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |