Individual
DR. RYAN NEWELL BULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, DHSC
Contact information
Practice address
1845 MCCULLOCH BLVD N STE A1, LAKE HAVASU CITY, AZ 86403-5722
(928) 855-7700
Mailing address
335 W BELLO VISTA PLZ, KINGMAN, AZ 86409-2975
(801) 787-6883
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8693
AZ
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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