Individual
BRIAN BECKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1091 N BLUFF ST STE 550, ST GEORGE, UT 84770
(435) 628-6200
(435) 652-9051
Mailing address
1091 N BLUFF ST STE 550, ST GEORGE, UT 84770-5775
(435) 628-6200
(435) 652-9051
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9366743-9921
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S3-248
NV
Other
Enumeration date
04/10/2011
Last updated
11/20/2018
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