# BISHOP DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRAIRIE VISTA DENTAL, LLC
- **Other names:** Prairie Vista Dental, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063292738
- **Legal business name:** PRAIRIE VISTA DENTAL, LLC
- **Authorized official:** BRADYN BISHOP DDS (DENTIST)
- **Authorized official phone:** (801) 879-8381

## Contact information

- **Practice address:** 209 W CENTRAL AVE, ULYSSES, KS 67880-2404
- **Practice address phone:** (620) 424-4311
- **Mailing address:** 209 W CENTRAL AVE, ULYSSES, KS 67880-2404
- **Mailing address phone:** (620) 424-4311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2023
- **Last updated:** 10/02/2023