Organization
BISHOP DENTAL, LLC
Active
Parent organization
PRAIRIE VISTA DENTAL, LLC
Other names
Prairie Vista Dental, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRAIRIE VISTA DENTAL, LLC
Authorized official
BRADYN BISHOP DDS (DENTIST)
(801) 879-8381
Entity
Organization
Contact information
Practice address
209 W CENTRAL AVE, ULYSSES, KS 67880-2404
(620) 424-4311
Mailing address
209 W CENTRAL AVE, ULYSSES, KS 67880-2404
(620) 424-4311
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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