| Organization Name: | VINCENT SURGICAL ARTS, LLC |
| NPI Number: | 1538572169 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DRAKE G VINCENT (MEDICAL DIRECTOR) |
| Mailing Address: | 6710 S Blackstone Rd Suite 201 Cottonwood Heights |
| State: | UT US |
| Postal Code: | 841216072 |
| Phone Number: | 8019421111 |
| Fax Number: | 8019421188 |
| NPI Enumeration Date: | 06/11/2014 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | 5767298-8905 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |