Provider Demographics
NPI:1497853766
Name:BULT, FAITH R (DDS)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:R
Last Name:BULT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 32ND ST
Mailing Address - Street 2:STE 100
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-0951
Mailing Address - Country:US
Mailing Address - Phone:360-715-3333
Mailing Address - Fax:360-715-8338
Practice Address - Street 1:405 32ND ST
Practice Address - Street 2:STE 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-0951
Practice Address - Country:US
Practice Address - Phone:360-715-3333
Practice Address - Fax:360-715-8338
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE9293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist