NPI | 1164422739 |
---|---|
Doing Business As | SCOTT E BULLOCH DDS, MS |
Entity Type | Organization |
Authorized Contact | SCOTT EDWIN BULLOCH President 435-652-1445 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: UT 273596-9924) |
Enumeration Date | 2005-07-26 |
Last Update Date | 2017-10-12 |