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1952244642
BRIGHTSIDE ORAL SURGERY LLC
STANSBURY PARK, UT
NPI
1952244642
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Entity Type
Organization
Authorized Contact
EBONIE GONZALES
Credentialing Manager
505-850-3769
Organization Subpart ?
No
Primary Taxonomy
204E00000X Oral & Maxillofacial Surgery
Enumeration Date
2026-04-09
Last Update Date
2026-04-09
Business Address
BRIGHTSIDE ORAL SURGERY LLC
5136 N CAMBRIDGE WAY
STANSBURY PARK, UT 84074-8279
Phone number: 801-773-8644
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Mailing Address
BRIGHTSIDE ORAL SURGERY LLC
5136 N CAMBRIDGE WAY
STANSBURY PARK, UT 84074-8279
Phone number: 801-773-8644
Copy