Individual
CARL BRUCE BULLEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1143 RIATA VALLEY RD, KINGMAN, AZ 86409-2978
(928) 757-8700
Mailing address
1143 RIATA VALLEY RD, KINGMAN, AZ 86409-2978
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3921
AZ
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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