NPI | 1114781689 |
---|---|
Doing Business As | RIVERWOOD ORAL & MAXILLOFACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | MAURICE GUSTAF JENKINS Owner 801-437-7701 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2024-02-06 |
Last Update Date | 2024-02-06 |