Individual
DR. BONIFACIO GUILLENA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1404 SUNRIVER PKWY STE 125, ST GEORGE, UT 84790-4824
(435) 256-6167
Mailing address
290 E CALGARY DR, ST GEORGE, UT 84790-7242
(801) 372-9585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8712331-9922
UT
Other
Enumeration date
11/10/2013
Last updated
11/10/2013
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