Individual
SCOTT EDWIN BULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
754 S MAIN ST, SUITE 5, ST GEORGE, UT 84770
(435) 652-1445
(435) 652-0138
Mailing address
754 S MAIN ST, SUITE 5, ST GEORGE, UT 84770
(435) 652-1445
(435) 652-0138
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2735969224
UT
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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