| Organization Name: | ORAL & MAXILLOFACIAL IMAGING CENTER, INC. |
| NPI Number: | 1013069848 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DUANE R. PERRY (PRESIDENT) |
| Mailing Address: | 7001 S 900 E Suite 310 Midvale |
| State: | UT US |
| Postal Code: | 840471718 |
| Phone Number: | 8012558899 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 292200000X |
| License Number: | 39396 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Dental Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A commercial laboratory specializing in the construction of dental appliances that conform to a dentist |