Individual
CHANDLER BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6217 OAKMONT BLVD, FORT WORTH, TX 76132-2812
(682) 224-1464
Mailing address
6217 OAKMONT BLVD, FORT WORTH, TX 76132-2812
(682) 224-1464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34288
TX
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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