Individual
JUAN J ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2815 16TH ST SW, MINOT, ND 58701-6914
(701) 857-2900
(701) 857-2910
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 857-5650
(701) 857-5031
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41434
—
ND
Enumeration date
07/13/2007
Last updated
05/25/2012
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