Individual
DR. CRAIG B. BULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4602 SOUTHERN PKWY, SUITE 2E, LOUISVILLE, KY 40214-1442
(502) 361-1232
(502) 361-1242
Mailing address
4602 SOUTHERN PKWY, SUITE 2E, LOUISVILLE, KY 40214-1442
(502) 361-1232
(502) 361-1242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4888
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60048881
—
KY
01
—
Y118
FEDERAL BC/BS KY
KY
Enumeration date
08/12/2005
Last updated
01/11/2008
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