Provider Demographics
NPI:1629356019
Name:MULLINS, BARBARA A (RDH, BS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:MULLINS
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73506
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28307-6506
Mailing Address - Country:US
Mailing Address - Phone:850-281-3579
Mailing Address - Fax:
Practice Address - Street 1:BUILDING C-6238 ARDENNES DRIVE
Practice Address - Street 2:LAFLAMME DENTAL CLINIC
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-432-8170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH12117124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist