| NPI | 1669662425 | 
|---|---|
| Doing Business As | WASATCH ORAL SURGERY | 
| Entity Type | Organization | 
| Authorized Contact | KYLE S CHRISTENSEN Owner 801-561-8088 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery | 
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery | 
| Enumeration Date | 2007-07-27 | 
| Last Update Date | 2007-07-27 |