Individual
BRYCE RICHARD BULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
801 NEWTON RD, IOWA CITY, IA 52242-8004
(435) 680-8962
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(435) 680-8962
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RES-30694
IA
Other
Enumeration date
05/20/2024
Last updated
12/01/2024
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