Organization
SOUTHWEST ORAL AND FACIAL SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED MATHEW BROWN D.D.S, M.D (OWNER/SURGEON)
(801) 938-3412
Entity
Organization
Contact information
Practice address
11748 S 3600 W, SUITE 1, SOUTH JORDAN, UT 84095-5922
(801) 938-3412
(801) 938-3413
Mailing address
11748 S 3600 W, SUITE 1, SOUTH JORDAN, UT 84095-5922
(801) 938-3412
(801) 938-3413
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
355097-9924
UT
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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