Provider Demographics
NPI:1013357193
Name:ROBERT H. GULLER, DMD
Entity Type:Organization
Organization Name:ROBERT H. GULLER, DMD
Other - Org Name:PASCACK DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:GULLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-391-5565
Mailing Address - Street 1:21 S KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2112
Mailing Address - Country:US
Mailing Address - Phone:201-391-5565
Mailing Address - Fax:201-391-8747
Practice Address - Street 1:21 S KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2112
Practice Address - Country:US
Practice Address - Phone:201-391-5565
Practice Address - Fax:201-391-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01671500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty