Organization
INTERMOUNTAIN ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK RYSER DMD (ORAL SURGEON)
(801) 261-2444
Entity
Organization
Contact information
Practice address
6287 S REDWOOD RD, #103, TAYLORSVILLE, UT 84123-6634
(801) 261-2444
Mailing address
6287 S REDWOOD RD, #103, TAYLORSVILLE, UT 84123-6634
(801) 261-2444
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
LIC-4-12-7785
UT
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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