Bullen & Wilson Eaglegate College Dental Clinic

NPI #1962635466 in Murray, Utah

Provider Information

NPI Number: 1962635466
Entity Type: Organization
Organization Name: Bullen & Wilson Eaglegate College Dental Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: BULLEN & WILSON EAGLEGATE COLLEGE
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 31, 2009
Last Updated: Aug 31, 2009

Practice Location

Address: 5618 GREEN ST
City: Murray
State: Utah
ZIP Code: 84123-5796
Phone: (801) 333-8138

Authorized Official

Name: MS. HOLLI D STEWART, CDA
Title: CLINIC MANAGER
Phone: (801) 333-8138

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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