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Organization

JOHN A. BULLOCK DMD LLC

Active
Other names
Bullock Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN A BULLOCK DMD (MANAGING MEMBER)
(503) 691-9400
Entity
Organization

Contact information

Practice address
18813 SW MARTINAZZI AVE, TUALATIN, OR 97062-6807
(503) 691-9400
(503) 691-9439
Mailing address
18813 SW MARTINAZZI AVE, TUALATIN, OR 97062-6807
(503) 691-9400
(503) 691-9439

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
05/23/2009
Last updated
05/23/2009
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