| NPI | 1053596429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG A ROBERTS Oral & Maxillofacial Surgeon 801-479-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 1451579924) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-01-04 |