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General NPI Number Information
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NPI Number | 1891629283
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Entity Type | Individual
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Provider Name | ANNA ELIZABETH BULLARD DDS
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 401 N ILLINOIS ST APT 3H
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-1224
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Country | US
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Telephone | 812-498-7503
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Fax |
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Provider Business Mailing Address
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Address Line | 401 N ILLINOIS ST APT 3H
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-1224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12015057A
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License Number State | IN
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