NPI | 1194267724 |
---|---|
Doing Business As | ELEVATE ORAL AND FACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | JAMES HAYNIE BARTON President 435-287-4455 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 95126489924) |
Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: UT 95126481205) |
Enumeration Date | 2016-11-14 |
Last Update Date | 2016-12-07 |