Individual
DR. JONATHAN BULTEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
594 MAIN ST N, HORACE, ND 58047-4640
(701) 552-6001
(701) 781-8056
Mailing address
594 MAIN ST N, HORACE, ND 58047-4640
(701) 552-6001
(701) 781-8056
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
13339
MN
122300000X
Dentist
D1036
SD
1223G0001X
General Practice Dentistry
Primary
2046
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1451030
—
ND
Enumeration date
02/05/2010
Last updated
02/07/2017
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