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Individual

DR. JOHN WILLIAM HULTQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MD

Contact information

Practice address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-5044
(210) 292-4946
Mailing address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-5044
(210) 292-4946

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4705
AL

Other

Enumeration date
09/16/2005
Last updated
09/13/2010
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