Individual
DR. JASON SCOTT BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
BLDG 38717 38TH STREET, USA DENTAL ACTIVITY, FORT GORDON, GA 30905-5660
(706) 787-6927
(706) 787-2082
Mailing address
BLDG 38717 38TH STREET, USA DENTAL ACTIVITY, FORT GORDON, GA 30905-5660
(706) 787-6927
(706) 787-2082
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7840
KY
Other
Enumeration date
04/27/2006
Last updated
05/20/2015
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