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Organization
VINEYARD ORAL AND MAXILLOFACIAL SURGERY
Active
Organization
VINEYARD ORAL AND MAXILLOFACIAL SURGERY
Active
Other names
Vineyard Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON SHIELDS (OFFICE MANAGER)
(801) 766-4834
Entity
Organization
Contact information
Practice address
707 E MILL RD STE 102, VINEYARD, UT 84059-5732
(801) 766-4834
(801) 766-2315
Mailing address
3300 N RUNNING CREEK WAY STE H210, LEHI, UT 84043-5871
(801) 766-4834
(801) 766-2315
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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