Organization
LEGACY HEIGHTS ORAL & FACIAL SURGERY PLLC
Active
Other names
Legacy Heights Oral & Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DAYNE ROBERT JENSEN MD, DMD (OWNER/ORAL SURGEON)
(801) 698-7121
Entity
Organization
Contact information
Practice address
193 S 200 W STE B, FARMINGTON, UT 84025-2406
(801) 698-7121
Mailing address
193 S 200 W STE B, FARMINGTON, UT 84025-2406
(801) 698-7121
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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