Shaun Bullard, D.M.D
Dentist in Jacksonville, FL. Individual provider (NPI-1).
NPI number1013385939
StatusActive
Last updated in NPPESSep 9, 2015
Details
- NPI
- 1013385939
- Entity type
- Individual (NPI-1)
- Name
- Shaun Bullard
- Credential
- D.M.D
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 9, 2015
- Last updated
- Sep 9, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN 21488 | FL | Yes |
Practice location
800 Dunn AveJacksonville, FL 32218-4803
Phone 904-751-0679
Mailing address
800 Dunn AveJacksonville, FL 32218-4803
Phone 904-751-0679
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