Individual
DR. GLORIA E BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1525 E 53RD ST, SUITE 632, CHICAGO, IL 60615-4557
(773) 241-6401
Mailing address
1525 E 53RD STREET, SUITE 632, CHICAGO, IL 60615
(773) 241-6401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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