Bloomington Dental PC
Dentist in St George, UT. Organization (NPI-2).
NPI number1922456482
StatusActive
Last updated in NPPESMay 25, 2016
Details
- NPI
- 1922456482
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloomington Dental PC
- Organization subpart
- No
- Enumeration date
- May 25, 2016
- Last updated
- May 25, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
169 W 2710 South CirSte 102
St George, UT 84790-7201
Phone 435-674-9977
Mailing address
169 W 2710 South CirSte 102
St George, UT 84790-7201
Phone 435-674-9977
Authorized official
Chris Neilson
Owner
4356749977
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