Provider Demographics
NPI:1427234731
Name:BULFA, GEORGE CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CHRISTOPHER
Last Name:BULFA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-4151
Mailing Address - Country:US
Mailing Address - Phone:219-942-1730
Mailing Address - Fax:219-942-0742
Practice Address - Street 1:250 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-4151
Practice Address - Country:US
Practice Address - Phone:219-942-1730
Practice Address - Fax:219-942-0742
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009297A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2005344020Medicaid