| Precision Dental Specialties Pllc | |
|
754 S Main St Ste 5 St George UT 84770-5519 | |
| (435) 652-1445 | |
| Not Available |
| Full Name | Precision Dental Specialties Pllc |
|---|---|
| Speciality | Dentist |
| Location | 754 S Main St Ste 5, St George, Utah |
| Authorized Official Name and Position | Brandon Scott Bulloch (DOCTOR) |
| Authorized Official Contact | 4356521445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Precision Dental Specialties Pllc 754 S Main St Ste 5 St George UT 84770-5519 Ph: (435) 652-1445 | Precision Dental Specialties Pllc 754 S Main St Ste 5 St George UT 84770-5519 Ph: (435) 652-1445 |
| NPI Number | 1912766882 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 04/30/2024 |
| Medicare PECOS PAC ID | 3779922364 |
|---|---|
| Medicare Enrollment ID | O20240416000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912766882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Brett W Bulloch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104055821 PECOS PAC ID: 4789840851 Enrollment ID: I20120718000618 |
| Provider Name | Brandon S Bulloch |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336880913 PECOS PAC ID: 8123464047 Enrollment ID: I20240416002812 |
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