Organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Active
Parent organization
UT OMS SPECIALTY DENTAL SERVICES PLLC
Other names
Utah Orthofacial Surgery
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
4046 S HIGHLAND DR STE 112, SALT LAKE CITY, UT 84124-1687
(801) 273-5600
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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