Individual
DR. JON BUFORD DULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1812 W MCGALLIARD RD, MUNCIE, IN 47304-2209
(765) 282-7320
Mailing address
1812 W MCGALLIARD RD, MUNCIE, IN 47304-2209
(765) 282-7320
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008566A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12008566A
DENTAL LICENSE
IN
Enumeration date
01/08/2007
Last updated
07/08/2007
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