Individual
BRANDON SCOTT BULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3394 N FUTRALL DR STE 2, FAYETTEVILLE, AR 72703-3937
(479) 582-3360
Mailing address
3394 N FUTRALL DR STE 2, FAYETTEVILLE, AR 72703-3937
(479) 582-3360
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4795
AR
Other
Enumeration date
04/06/2022
Last updated
08/14/2024
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