NPI | 1962918094 |
---|---|
Doing Business As | ORAL & FACIAL SURGERY INSTITUTE |
Entity Type | Organization |
Authorized Contact | SHAWN B DAVIS Owner 435-628-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: UT 6524667) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AZ D07932) |
Enumeration Date | 2017-12-27 |
Last Update Date | 2017-12-27 |