| NPI | 1760745251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RYSER Oral Surgeon 801-261-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT LIC-4-12-7785) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |