ORAL SURGERY SPECIALTY
Organization (NPI-2)
Active
Oral & Maxillofacial Surgery
Provider Information
- NPI Number
1790089886- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 3648 W 9800 S, SOUTH JORDAN, UT, 840953260
- Phone
- (801) 397-2727
Specialties & Taxonomies
Oral & Maxillofacial Surgery
Primary License: UT #135181