Organization
CHARLIE BULLER III DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLIE BULLER III DDS (OWNER)
(337) 582-7225
Entity
Organization
Contact information
Practice address
206 THOMSON AVE., IOWA, LA 70647-1179
(337) 582-7225
(337) 582-4867
Mailing address
PO BOX 1179, IOWA, LA 70647-1179
(337) 582-7225
(337) 582-4867
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4022
LA
122300000X
Dentist
6173
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1840220
—
LA
Enumeration date
07/11/2011
Last updated
07/11/2011
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