| Dr. Blaine D. Austin Dds | |
|
1250 East 3900 South Suite 210 Salt Lake City UT 84124 | |
| (801) 264-1500 | |
| (801) 265-9963 |
| Full Name | Dr. Blaine D. Austin Dds |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1250 East 3900 South, Salt Lake City, Utah |
| Authorized Official Name and Position | Blaine D Austin (ORAL MAXILLO-FACIAL SURGERY) |
| Authorized Official Contact | 8017594378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Blaine D. Austin Dds 1250 E 3900 S Ste 210 Salt Lake City UT 84124-1367 Ph: (801) 265-1500 | Dr. Blaine D. Austin Dds 1250 East 3900 South Suite 210 Salt Lake City UT 84124 Ph: (801) 264-1500 |
| NPI Number | 1679089239 |
|---|---|
| Provider Enumeration Date | 12/19/2017 |
| Last Update Date | 01/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679089239 | NPI | - | NPPES |
| U000005310 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 140958 (Utah) | Primary |
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