Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DF10808 | MA |
NPI | 1093065179 |
---|---|
Provider Name | Dr. Gulsun Gul |
First Address | Cambridge, MA 02142-1200 |
Second Address | Cambridge, MA 02142-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 14/09/2012 |