| NPI | 1356084107 |
|---|---|
| Former Legal Business Name | ST. GEORGE RED ROCKS PC |
| Entity Type | Organization |
| Authorized Contact | DAYNE R JENSEN Oral Surgeon/Owner 801-997-9017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-10-06 |