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Individual
DR. JEFFREY AVARON OSGUTHORPE
Active
Individual
DR. JEFFREY AVARON OSGUTHORPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2901018951
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4947070-9924
UT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2901018951
MI
Other
Enumeration date
11/06/2006
Last updated
04/15/2019
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