| Ut Oms Specialty Dental Services Pllc | |
|
777 N 500 W Ste 102 Provo UT 84601-1598 | |
| (801) 341-2428 | |
| Not Available |
| Full Name | Ut Oms Specialty Dental Services Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 777 N 500 W Ste 102, Provo, Utah |
| Authorized Official Name and Position | Charlotte E Vial (DIRECTOR OF CRED AND PR) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ut Oms Specialty Dental Services Pllc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (615) 678-0759 | Ut Oms Specialty Dental Services Pllc 777 N 500 W Ste 102 Provo UT 84601-1598 Ph: (801) 341-2428 |
| NPI Number | 1235996174 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 03/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235996174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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