Provider Demographics
NPI:1992318455
Name:BIO-AESTHETICS DENTAL STUDIO INC
Entity type:Organization
Organization Name:BIO-AESTHETICS DENTAL STUDIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:TECH
Authorized Official - Phone:970-424-5182
Mailing Address - Street 1:1001 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7580
Mailing Address - Country:US
Mailing Address - Phone:970-424-5182
Mailing Address - Fax:
Practice Address - Street 1:1001 N 3RD ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7580
Practice Address - Country:US
Practice Address - Phone:970-424-5182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory