Individual provider · Type 1 NPI

Grant B. Cannon, DDS, MD

Oral and Maxillofacial Surgery (Dentist) · Salt Lake City, UT

NPI number 1467678938 Active

Practice location

4190 Highland Dr, Suite 112
Salt Lake City, UT 84124-2600

Call (801) 272-9241 Map

Fax (801) 277-9760

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X133953 (UT)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1467678938

Grant B. Cannon, DDS, MD's National Provider Identifier is 1467678938, issued on Apr 17, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Salt Lake City, UT. The record was last updated on Nov 11, 2021.