Individual
MRS. CAROLYN DEOLINDA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
320 5TH ST, FREDERICK, CO 80530
(303) 833-3230
(303) 833-4477
Mailing address
P.O. BOX 69, FREDERICK, CO 80530
(303) 833-3230
(303) 833-4477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D07836
AZ
Other
Enumeration date
01/10/2011
Last updated
11/16/2018
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