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Organization

BULLEN ORTHODONTICS INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RYAN N. BULLEN (ORTHODONTIST)
(801) 787-6883
Entity
Organization

Contact information

Practice address
1143 RIATA VALLEY RD, KINGMAN, AZ 86409
(928) 757-8700
(928) 757-0399
Mailing address
1143 RIATA VALLEY RD, KINGMAN, AZ 86409
(928) 757-8700
(928) 757-0399

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3927
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D3927
AZ

Other

Enumeration date
05/30/2018
Last updated
05/30/2018
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