Ut Oms Specialty Dental Services PLLC
Dentist, Oral and Maxillofacial Surgery in Salt Lake City, UT. Organization (NPI-2).
NPI number1407613342
StatusActive
Last updated in NPPESMar 5, 2024
Details
- NPI
- 1407613342
- Entity type
- Organization (NPI-2)
- Legal business name
- Ut Oms Specialty Dental Services PLLC
- Organization subpart
- Yes
- Enumeration date
- Mar 5, 2024
- Certification date
- Mar 5, 2024
- Last updated
- Mar 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | Yes |
Other names
- Utah Orthofacial Surgery (Doing Business As)
Practice location
4046 S Highland Dr Ste 112Salt Lake City, UT 84124-1687
Phone 801-273-5600
Mailing address
1610 54th Ave N Ste 205Nashville, TN 37209-1442
Phone 615-678-0759
Authorized official
Charlotte E Vial
Director Of Cred And Pr
5046380303
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