Jonathan Bultema D.D.S.

NPI 1669704300 - Dentist - 122300000X

NPI Details
NPI 1669704300
Gender Male
Enumeration Date 02/05/2010
Last Updated 08/21/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
715 11TH ST N
SUITE 106B
MOORHEAD MN, 56560-2083, US
Phone (701) 271-3344
Fax (701) 551-1510
Business Location
301 NP AVE N
FARGO ND, 58102-4835, US
Phone (701) 446-8250
Fax
Toxanomy
Taxonomy Code 122300000X
License State South Dakota
License Number D1036
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According to our database, Dr. Jonathan Bultema D.D.S. NPI is 1669704300, taxonomy code is 122300000X and license number is D1036, license state is located at South Dakota. Jonathan Bultema D.D.S. physically located at 715 11th St N, Moorhead MN, 56560-2083. NPI Number Jonathan Bultema D.D.S. has the Individual type.

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1669704300 NPI number is provided on an as is basis without warranty of any kind. 1669704300 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Bultema D.D.S. are for informational purposes only.