Organization
PRECISION IMPLANT & ORAL SURGERY PC
Active
Other names
Scott E Bulloch DDS, MS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT EDWIN BULLOCH DDS, MS (PRESIDENT)
(435) 652-1445
Entity
Organization
Contact information
Practice address
754 S MAIN ST, SUITE 5, ST GEORGE, UT 84770-5504
(435) 652-1445
(435) 652-0138
Mailing address
754 S MAIN ST, SUITE 5, ST GEORGE, UT 84770-5504
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
273596-9924
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
562454357012
—
UT
Enumeration date
07/26/2005
Last updated
10/12/2017
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