# INSTITUTE OF FACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265656227
- **Authorized official:** DR. BRENT D KENNEDY M.D. (DIRECTOR)
- **Authorized official phone:** (801) 261-3637

## Contact information

- **Practice address:** 5929 FASHION BLVD, MURRAY, UT 84107-7364
- **Practice address phone:** (801) 261-3637
- **Practice address fax:** (801) 261-4096
- **Mailing address:** 5929 FASHION BLVD, MURRAY, UT 84107-7364
- **Mailing address phone:** (801) 261-3637
- **Mailing address fax:** (801) 261-4096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2001ASF0602 | UT | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020