Organization
WISDOM TEETH CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH S MAIO D.D.S. (OWNER/DENTIST)
(801) 566-8833
Entity
Organization
Contact information
Practice address
263 COUNTRY CLB STE 103, STANSBURY PARK, UT 84074-9602
(801) 566-8833
Mailing address
PO BOX 708130, SANDY, UT 84070-8130
(801) 566-8833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
341237
UT
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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