Provider Demographics
NPI:1528513645
Name:JULIE BUCHANAN CORPORATION
Entity type:Organization
Organization Name:JULIE BUCHANAN CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-628-6168
Mailing Address - Street 1:382 S BLUFF ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3646
Mailing Address - Country:US
Mailing Address - Phone:435-628-6168
Mailing Address - Fax:435-628-2208
Practice Address - Street 1:382 S BLUFF ST STE 200
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3646
Practice Address - Country:US
Practice Address - Phone:435-628-6168
Practice Address - Fax:435-628-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53346331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1629148465OtherGENERAL DENTIST
UT1023025939OtherGENERAL DENTSIST
UT1548309735OtherGENERAL DENTIST