| NPI | 1184004970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN HUGH BULLEN Dds 765-653-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009005) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |