Individual
DR. LARRY JOEL BULLOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
210A 88TH ST, VIRGINIA BEACH, VA 23451-1828
(757) 437-9005
Mailing address
1550 TOMCAT BLVD, VIRGINIA BEACH, VA 23460-2218
(757) 314-7190
(757) 314-7064
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008405
VA
Other
Enumeration date
01/19/2006
Last updated
07/08/2007
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