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General NPI Number Information
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NPI Number | 1487580569
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Entity Type | Individual
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Provider Name | BIANCA BERNARDO AFONSO AGUIRRES DMD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 6973 S COUGAR LN STE D
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City | WEST JORDAN
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State | UT
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Zip | 84084-7927
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Country | US
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Telephone | 801-982-0332
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Fax |
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Provider Business Mailing Address
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Address Line | 2354 E SPRING ST
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City | EAGLE MOUNTAIN
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State | UT
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Zip | 84005-6543
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Country | US
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Telephone | 385-270-7374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14290510-9926
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License Number State | UT
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