Individual
DR. STEVE THOMAS TOSHIO BULLOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1385 LASKIN RD, VIRGINIA BEACH, VA 23451-6089
(757) 425-1547
(757) 425-6603
Mailing address
2512 SEAVIEW AVE, VIRGINIA BEACH, VA 23455-1448
(757) 460-0433
(757) 425-6603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00401005556
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6145
DORAL DENTAL
—
05
—
8991174
—
NC
Enumeration date
11/30/2005
Last updated
07/08/2007
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