Individual
DR. ROY HARRELL BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
125 COLISEUM BLVD, MONTGOMERY, AL 36109-2707
(334) 272-0110
(334) 272-3178
Mailing address
125 COLISEUM BLVD, MONTGOMERY, AL 36109-2707
(334) 272-0110
(334) 272-3178
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4146
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92549
BCBS PROVIDER NUMBER
AL
Enumeration date
10/19/2006
Last updated
07/08/2007
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