Wisdom Teeth Centers LLC

NPI #1295212884 in Stansbury Park, Utah

Provider Information

NPI Number: 1295212884
Entity Type: Organization
Organization Name: Wisdom Teeth Centers LLC
Primary Specialty: Dentist
Enumeration Date: Jul 26, 2018
Last Updated: Jul 26, 2018

Practice Location

Address: 263 COUNTRY CLB STE 103
City: Stansbury Park
State: Utah
ZIP Code: 84074-9602
Phone: (801) 566-8833

Authorized Official

Name: DR. JOSEPH S MAIO, D.D.S.
Title: OWNER/DENTIST
Phone: (801) 566-8833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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