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Organization
SUMMIT ORAL & MAXILLOFACIAL SURGERY
Active
Organization
SUMMIT ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J DURANT (COLLECTION MANAGER)
(801) 265-1500
Entity
Organization
Contact information
Practice address
1250 E 3900 S, STE 210, SALT LAKE CITY, UT 84124-1348
(801) 265-1500
(801) 265-9963
Mailing address
1250 E 3900 S STE 210, SALT LAKE CITY, UT 84124-1367
(801) 265-1500
(801) 265-9963
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7835316
UT
Other
Enumeration date
06/22/2015
Last updated
06/23/2015
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