NPI 1083569396

Brightside Oral Surgery LLC

Organisation Oral & Maxillofacial Surgery (D.M.D.) Roy, UT

Practice location

Address: 5682 S 3500 W Unit a, Roy, UT 84067-9108
Phone: (801) 773-9828
Fax: (801) 773-9828

Authorised official

Name: Ebonie Gonzales
Title: Credentialing Manager
Phone: (505) 850-3769

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X

Other Oral & Maxillofacial Surgery providers in Utah →

Registry record

NPI: 1083569396
Entity type: Organization
NPI issued: 2 Mar 2026
Record last updated: 2 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.