Ut Oms Specialty Dental Services Pllc

NPI #1235996174 in Provo, Utah

Provider Information

NPI Number
1235996174
Entity Type
Organization
Organization Name
Ut Oms Specialty Dental Services Pllc
Subpart
Yes (part of a larger organization)
Parent Organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Enumeration Date
Mar 5, 2024
Last Updated
Mar 5, 2024

Practice Location

Address
777 N 500 W STE 102
City
Provo
State
Utah
ZIP Code
84601-1598
Phone
(801) 341-2428

Authorized Official

Name
CHARLOTTE E VIAL
Title
DIRECTOR OF CRED AND PR
Phone
(504) 638-0303

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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