Organization
DR. GREG A. ROBERTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG A ROBERTS DDS (ORAL & MAXILLOFACIAL SURGEON)
(801) 479-9070
Entity
Organization
Contact information
Practice address
5742 S 1475 E STE 100, OGDEN, UT 84403-4857
(801) 479-9070
(801) 479-9078
Mailing address
5742 S 1475 E STE 100, OGDEN, UT 84403-4857
(801) 479-9070
(801) 479-9078
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1451579924
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356358535
INDIVIDUAL NPI TYPE 1
—
05
—
529989109028
—
UT
Enumeration date
01/04/2008
Last updated
01/04/2008
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