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General NPI Number Information
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NPI Number | 1457553745
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Entity Type | Organization
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Legal Business Name | DANIEL S BETHERS DDS PC
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 1224 S RIVER RD BUILDING E SUITE 2
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City | SAINT GEORGE
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State | UT
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Zip | 84790-8285
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Country | US
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Telephone | 435-674-7430
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Fax | 435-652-9532
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Provider Business Mailing Address
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Address Line | 1224 S RIVER RD BUILDING E SUITE 2
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City | SAINT GEORGE
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State | UT
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Zip | 84790-8285
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Country | US
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Telephone | 435-674-7430
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Fax | 435-652-9532
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL S BETHERS
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Credential | DDS
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Telephone | 435-674-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 5895914-9921
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License Number State | UT
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