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Organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Active
Organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE V DASCH (DIRECTOR OF PROVIDER RELATIONS)
(615) 678-0759
Entity
Organization
Contact information
Practice address
777 N 500 W STE 102, PROVO, UT 84601-1598
(801) 750-9672
Mailing address
401 CHURCH ST STE 1400, NASHVILLE, TN 37219-2214
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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