Provider Demographics
NPI:1386931871
Name:DR. CHRIS BULLINGTON D.D.S
Entity type:Organization
Organization Name:DR. CHRIS BULLINGTON D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BULLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-639-6129
Mailing Address - Street 1:1338 TUSCULUM BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4218
Mailing Address - Country:US
Mailing Address - Phone:423-639-6129
Mailing Address - Fax:423-639-6129
Practice Address - Street 1:1338 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4218
Practice Address - Country:US
Practice Address - Phone:423-639-6129
Practice Address - Fax:423-639-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1134304066OtherTYPE 1 NPI NUMBER