Bettina Bullard

Individual provider Active NPI Dental Hygienist · Maxton, NC

NPI 1306298609 · NPPES record last updated Jul 11, 2016

Key facts

NPI
1306298609
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
7515 (NC)
Practice address
773 John L Rd
Maxton, NC 28364-8843
Phone
(910) 740-0113
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 7515 NC Yes

Addresses

Primary practice location

773 John L Rd
Maxton, NC 28364-8843

Mailing address

3718 Gruber Rd
Fort Bragg, NC 28310-8934

Other providers in Maxton, NC

All providers in Maxton, NC · Dental Hygienist in North Carolina

Sources for this page

Verify at the official NPI Registry.