Organization
ISMILE IMPLANT AND SURGICAL CENTERA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RUSSELL (OFFICE MANAGER)
(801) 879-2343
Entity
Organization
Contact information
Practice address
306 N MAIN ST, KAYSVILLE, UT 84037-6766
(801) 879-2343
Mailing address
306 N MAIN ST, KAYSVILLE, UT 84037-6766
(801) 879-2343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8367155
UT
Other
Enumeration date
10/17/2013
Last updated
10/17/2013
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