Individual
DR. JASON MATTHEW BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7101 HOFF ST, FORT BENNING, GA 31905-5645
(706) 544-4559
Mailing address
BUILDING 972 7061 LINCOLN AVENUE, USA DENTAL ACTIVITY, FORT BENNING, GA 31905
(706) 544-2118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8895
KY
Other
Enumeration date
08/23/2010
Last updated
03/30/2023
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