| NPI | 1679943831 |
|---|---|
| Other Name | CREEKSIDE ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | DAVID MAX ANDERSON President 801-255-2422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 315501-9924) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2016-06-30 |