Organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Active
Parent organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Other names
Burg Children's Dentistry & Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
UT OMS SPECIALTY DENTAL SERVICES PLLC
Authorized official
CHARLOTTE E VIAL (DIRECTOR OF CRED AND PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
8822 S REDWOOD RD # 201, WEST JORDAN, UT 84088-9336
(801) 727-8905
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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