Individual
DR. JOHN LYMAN BISHOP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1204 N MAIN ST, TOOELE, UT 84074-9540
(435) 882-8600
(435) 882-8481
Mailing address
5907 WINDSONG DR, STANSBURY PARK, UT 84074-8949
(435) 840-2016
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5259584
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1745643
UNITED CONCORDIA
UT
01
—
5259849901001
BLUE CROSS BLUE SHIELD
UT
01
—
82398
PEHP
UT
Enumeration date
06/16/2006
Last updated
07/08/2007
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