| NPI | 1912507153 |
|---|---|
| Doing Business As | LEGACY HEIGHTS ORAL & FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | DAYNE ROBERT JENSEN Owner/Oral Surgeon 801-698-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |