Blake M. Bullard, D.d.s., P.l.l.c.

NPI #1770993180 in Durant, Oklahoma

Provider Information

NPI Number: 1770993180
Entity Type: Organization
Organization Name: Blake M. Bullard, D.d.s., P.l.l.c.
Primary Specialty: Dentist
Enumeration Date: May 7, 2014
Last Updated: Jul 6, 2018

Practice Location

Address: 5008 W. UNIVERSITY BLVD.
City: Durant
State: Oklahoma
ZIP Code: 74701-2978
Phone: (580) 931-3366

Authorized Official

Name: BLAKE MICHAEL BULLARD, D.D.S.
Title: OWNER
Phone: (580) 931-3366

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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