| NPI | 1619050770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE H BULLARD Pediatric Dentist 920-452-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 5747) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |