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General NPI Number Information
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NPI Number | 1912919432
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Entity Type | Individual
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Provider Name | PAUL VERNON BAHLINGER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 51 S BRIAN MICKELSEN PKWY
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3610
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Country | US
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Telephone | 928-639-8132
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Fax | 866-274-8919
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Provider Business Mailing Address
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Address Line | 55 CATHEDRAL ROCK DR
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City | SEDONA
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State | AZ
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Zip | 86351-8630
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Country | US
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Telephone | 719-475-7946
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D09182
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9885
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License Number State | CO
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