Individual
CAL THOMAS BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2900 CENTRAL AVE, BILLINGS, MT 59102-8626
(406) 646-6100
Mailing address
2900 CENTRAL AVE, BILLINGS, MT 59102-8626
(406) 656-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
LL633
MD
122300000X
Dentist
LL674
MD
1223P0221X
Pediatric Dentistry
Primary
DEN-DEN-LIC-7748
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119591300
—
MD
Enumeration date
07/13/2012
Last updated
06/07/2017
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