| Organization Name: | JFMC PLLC |
| NPI Number: | 1093062978 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL GETZ CROOKSTON (CO-OWNER) |
| Mailing Address: | 2779 W 4000 S Ste 101 Roy |
| State: | UT US |
| Postal Code: | 840679603 |
| Phone Number: | 8017315528 |
| Fax Number: | 8017318369 |
| NPI Enumeration Date: | 08/09/2012 |
| NPI Last Update Date: | 08/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |