Provider Demographics
NPI:1780728964
Name:DINGMAN, BERNARD JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JOHN
Last Name:DINGMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 HIGHWAY 224 STE 201
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5952
Mailing Address - Country:US
Mailing Address - Phone:435-658-4746
Mailing Address - Fax:
Practice Address - Street 1:4343 HIGHWAY 224 STE 201
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5952
Practice Address - Country:US
Practice Address - Phone:435-658-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT360924122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist