PERIODONTAL SPECIALISTS NPI 1750574810

NPI Information

PERIODONTAL SPECIALISTS is a periodontics dentist in St George, UT. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL SPECIALISTS NPI is 1750574810. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

754 S MAIN ST STE 7
ST GEORGE, UT
ZIP 84770-517
Phone: (435) 652-1605
Fax: (435) 652-2046

The provider's authorized official is Thomas L Bradshaw .
The authorized official title is Periodontist and has the following contact phone number (435) 652-1605.

The enumeration date for this NPI number is 8/22/2007 and was last updated on 8/22/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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