Provider Demographics
NPI:1497124259
Name:FLINT & STEEL SURGICAL
Entity Type:Organization
Organization Name:FLINT & STEEL SURGICAL
Other - Org Name:UTAH ORAL & FACIAL SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:STOSICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:801-566-5117
Mailing Address - Street 1:4970 S 900 E
Mailing Address - Street 2:SUITE C
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5776
Mailing Address - Country:US
Mailing Address - Phone:801-263-3309
Mailing Address - Fax:801-288-1226
Practice Address - Street 1:4970 S 900 E
Practice Address - Street 2:SUITE C
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5776
Practice Address - Country:US
Practice Address - Phone:801-263-3309
Practice Address - Fax:801-288-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6434136-99241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty