Provider Demographics
NPI:1164671236
Name:PULIDO, GILBERT (DMD)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:
Last Name:PULIDO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 CLINTON AVENUE.
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07676
Mailing Address - Country:US
Mailing Address - Phone:201-358-2719
Mailing Address - Fax:
Practice Address - Street 1:649 CLINTON AVENUE
Practice Address - Street 2:
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07676
Practice Address - Country:US
Practice Address - Phone:201-358-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101419300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist