Healthcare Provider Details

I. General information

NPI: 1912652223
Provider Name (Legal Business Name): CHRISTOPHER TYLER ROLLINS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 S MAIN ST STE 7
ST GEORGE UT
84770-5517
US

IV. Provider business mailing address

276 W AUGUSTA DR
IVINS UT
84738-1284
US

V. Phone/Fax

Practice location:
  • Phone: 435-652-1605
  • Fax:
Mailing address:
  • Phone: 770-280-5697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number14213548-9925
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: