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Organization

B&G MANAGEMENT SERVICES LLC

Active
Other names
Masterpiece Dental
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL BRANDON GREEN DDS (DR. M. BRANDON GREEN DDS/ OWNER)
(801) 756-5136
Entity
Organization

Contact information

Practice address
186 S 1100 E, AMERICAN FORK, UT 84003-2817
(801) 756-5136
Mailing address
186 S 1100 E, AMERICAN FORK, UT 84003-2817
(801) 756-5136

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
6229925
UT

Other

Enumeration date
08/26/2016
Last updated
08/26/2016
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