Bullard Dental Group
NPI #1215185418 in Fresno, California
Provider Information
- NPI Number
- 1215185418
- Entity Type
- Organization
- Organization Name
- Bullard Dental Group
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 3, 2008
- Last Updated
- Sep 4, 2008
Practice Location
- Address
- 323 E BULLARD AVE
- Address 2
- SUITE 104
- City
- Fresno
- State
- California
- ZIP Code
- 93710-5213
- Phone
- (559) 439-9990
Authorized Official
- Name
- DR. MANDANA KOUROSHNIA, DDS
- Title
- PRESIDENT
- Phone
- (559) 439-9990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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