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Provider Information for 1477747913

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. D. BRYCE ALLDREDGE DMD

Gender: MALE

Individual NPI: 1477747913

Calendar   Last Updated:  2009-03-17
  Certification Date: 

Details

Name Value
NPI 1477747913
Enumeration Date 2007-08-28
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1240 E 100 S STE 17
ST GEORGE, UT 84790-3074
United States

Phone: 435-652-9105 | Fax: 435-652-9185
View Map External Link
Primary Practice Address 1240 E 100 S STE 17
ST GEORGE, UT 84790-3074
United States

Phone: 435-652-9105 | Fax: 435-652-9185
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice UT 6626945-9922
No 1223G0001X - Dentist General Practice NV 5871