Blake N Brog in Bountiful - Orthodontics And Dentofacial Orthopedics
Blake N Brog - NPI 1871624403
Blake N Brog is a Orthodontics And Dentofacial Orthopedics in Bountiful, Utah. Blake N Brog practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Blake N Brog is 1871624403. The last update date is 2007-07-08.
Blake N Brog's current location address is 469 Medical Dr, Bountiful, Utah. You can contact this provider via phone number 8012921888. The mailing address for Blake N Brog is 469 Medical Dr, Bountiful, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blake N Brog |
|---|---|
| Address | 469 Medical Dr, Bountiful, Utah |
| Phone Number | 8012921888 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1871624403 |
|---|---|
| Provider Enumeration Date | 2007-03-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 469 Medical Dr |
|---|---|
| City | Bountiful |
| State | Utah (UT) |
| Post Code | 840104900 |
| Phone Number | 8012921888 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | 142188-9921 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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Post Comment/ Review Below
What is the unique identifier code issued to Blake N Brog by the Centers for Medicare & Medicaid Services (CMS)?
The Blake N Brog has been assigned the NPI (National Provider Identifier) 1871624403. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Blake N Brog's facilities are geographically located?
The facilities of Blake N Brog are physically situated at the following location: 469 Medical Dr, Bountiful, UT, 840104900.
What is the area of specialization for Blake N Brog, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Blake N Brog is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code that categorizes this area of expertise is 1223X0400X.
On what date did the Blake N Brog receive the assignment of its 1871624403 from the Centers for Medicare & Medicaid Services?
The Blake N Brog was issued its 1871624403 by the Centers for Medicare & Medicaid Services on 2007-03-07.
As of what date were the details pertaining to Blake N Brog last refreshed?
The information related to the Blake N Brog, including its address, specialty, and other relevant details, was last updated on 2007-07-08.