Individual
JONATHAN L BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3702 WASHINGTON RD., AUGUSTA, GA 30907-2848
(706) 863-5337
(706) 855-8249
Mailing address
3702 WASHINGTON RD., AUGUSTA, GA 30907-2848
(706) 863-5337
(706) 855-8249
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6964
SC
1223G0001X
General Practice Dentistry
Primary
DN014101
GA
Other
Enumeration date
03/28/2011
Last updated
10/22/2011
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