Organization
KYLE S CHRISTENSEN, DDS, PC
Active
Other names
Wasatch Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE S CHRISTENSEN D.D.S. (OWNER)
(801) 561-8088
Entity
Organization
Contact information
Practice address
1268 W SOUTH JORDAN PKWY, SUITE 200, SOUTH JORDAN, UT 84095-4652
(801) 561-8088
(801) 562-8286
Mailing address
1268 W SOUTH JORDAN PKWY, SUITE 200, SOUTH JORDAN, UT 84095-4652
(801) 561-8088
(801) 562-8286
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550719194003
—
UT
Enumeration date
07/27/2007
Last updated
07/27/2007
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