| Intermountain Oral & Maxillofacial Surgery | |
|
6287 S Redwood Rd #103 Taylorsville UT 84123-6634 | |
| (801) 261-2444 | |
| Not Available |
| Full Name | Intermountain Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 6287 S Redwood Rd, Taylorsville, Utah |
| Authorized Official Name and Position | Mark Ryser (ORAL SURGEON) |
| Authorized Official Contact | 8012612444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Oral & Maxillofacial Surgery 6287 S Redwood Rd #103 Taylorsville UT 84123-6634 Ph: (801) 261-2444 | Intermountain Oral & Maxillofacial Surgery 6287 S Redwood Rd #103 Taylorsville UT 84123-6634 Ph: (801) 261-2444 |
| NPI Number | 1760745251 |
|---|---|
| Provider Enumeration Date | 06/19/2012 |
| Last Update Date | 06/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760745251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | LIC-4-12-7785 (Utah) | Primary |
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