Individual
JOSHUA BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1802 W KEARNEY ST, SPRINGFIELD, MO 65803-1647
(417) 567-8227
Mailing address
PO BOX 1832, PITTSBURG, KS 66762-1832
(620) 231-9873
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2020011311
MO
1223P0221X
Pediatric Dentistry
61581
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2018
Last updated
03/26/2024
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