Provider Demographics
NPI:1508033358
Name:FULMAN, GLORIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:FULMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 PATERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-4629
Mailing Address - Country:US
Mailing Address - Phone:973-256-3912
Mailing Address - Fax:973-785-2316
Practice Address - Street 1:245 PATERSON AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-4629
Practice Address - Country:US
Practice Address - Phone:973-256-3912
Practice Address - Fax:973-785-2316
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1023507001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice