Organization
GREGORY W EGBERT DDS MSD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY WILLIAM EGBERT DDS MSD (OWNER)
(801) 265-1500
Entity
Organization
Contact information
Practice address
1250 E 3900 SO, STE 210, SLC, UT 84124-1367
(801) 265-1500
(801) 265-1523
Mailing address
1250 E 3900 SO, STE 210, SLC, UT 84124-1367
(801) 265-1500
(801) 265-1523
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
143512
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528706087022
—
UT
Enumeration date
07/06/2006
Last updated
08/22/2020
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