| NPI | 1992930861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HYMAS WILLDEN Dr/Owner 801-446-4668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 53262349922) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |