Provider Demographics
NPI:1073700324
Name:HULSE, DANIEL LYNN (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LYNN
Last Name:HULSE
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 1:27066 SOUTH LA PAZ RD
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:949-360-9700
Mailing Address - Fax:949-362-5182
Practice Address - Street 1:1675 N PERRIS BLVD STE A1
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-4723
Practice Address - Country:US
Practice Address - Phone:949-360-9700
Practice Address - Fax:949-362-5182
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9410101OtherMEDICAL