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1922600287
BRENT MULLEN
FORT CAMPBELL, KY
NPI
1922600287
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IN 12013482A)
Enumeration Date
2020-11-12
Last Update Date
2020-11-12
Business Address
BRENT MULLEN
2441 21ST ST
FORT CAMPBELL, KY 42223-5582
Phone number: 270-798-8751
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Mailing Address
BRENT MULLEN
2441 21ST ST
FORT CAMPBELL, KY 42223-5582
Phone number: 270-798-8751
Copy
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