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General NPI Number Information
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NPI Number | 1073295382
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Entity Type | Organization
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Legal Business Name | FAMILIES FIRST ORAL SURGERY
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 5459 S. 7800 S. STE 100
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City | WEST JORDAN
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State | UT
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Zip | 84081
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Country | US
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Telephone | 801-515-5858
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Fax | 801-515-5859
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Provider Business Mailing Address
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Address Line | 1320 W SOUTH JORDAN PKWY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8847
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Country | US
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Telephone | 801-515-5858
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Fax |
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Authorized Official
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Title or Position | RMC MANAGER
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Name | ALISHA SHIGLEY
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Credential |
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Telephone | 801-450-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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