Organization
LEWISTON DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY JOHN BULLARD DDS (DENTIST/OWNER)
(507) 523-1071
Entity
Organization
Contact information
Practice address
560 DEBRA DR, LEWISTON, MN 55952
(507) 523-1071
(507) 523-1078
Mailing address
560 DEBRA DR, PO BOX 697, LEWISTON, MN 55952
(507) 523-1071
(507) 523-1078
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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