Organization
BLAKE M. BULLARD, D.D.S., P.L.L.C.
Active
Other names
Bullard Dental
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE MICHAEL BULLARD D.D.S. (OWNER)
(580) 931-3366
Entity
Organization
Contact information
Practice address
5008 W. UNIVERSITY BLVD., DURANT, OK 74701-2978
(580) 931-3366
(580) 931-3390
Mailing address
5008 W. UNIVERSITY BLVD., DURANT, OK 74701-2978
(580) 931-3366
(580) 931-3390
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6022
OK
Other
Enumeration date
05/07/2014
Last updated
07/06/2018
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