Individual
BETTINA BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
773 JOHN L RD, MAXTON, NC 28364-8843
(910) 740-0113
Mailing address
3718 GRUBER RD, FORT BRAGG, NC 28310-8934
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7515
NC
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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