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 |