Organization
VINEYARD ORAL AND MAXILLOFACIAL SURGERY
Active
Other names
Vineyard Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON SHIELDS (OFFICE MANAGER)
(801) 766-4834
Entity
Organization
Contact information
Practice address
707 E MILL RD STE 102, VINEYARD, UT 84059-5732
(801) 766-4834
(801) 766-2315
Mailing address
3300 N RUNNING CREEK WAY STE H210, LEHI, UT 84043-5871
(801) 766-4834
(801) 766-2315
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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