OrganizationActive
Brightside Oral Surgery LLC
NPI 1083569396 · Oral & Maxillofacial Surgery (D.M.D.) · Roy, UT
Provider details
- NPI number
- 1083569396
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Authorized official
- Ebonie Gonzales, Credentialing Manager
Practice location
5682 S 3500 W Unit a
Roy, UT 84067-9108
Phone: (801) 773-9828
Fax: (801) 773-9828
Mailing address
5682 S 3500 W Unit a
Roy, UT 84067-9108
Registry dates
- Enumerated
- 2026-03-02
- Last updated
- 2026-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.