Provider Demographics
NPI:1609275957
Name:PULIDO DENTAL CARE
Entity Type:Organization
Organization Name:PULIDO DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-477-7272
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:BUILDING 2 SUITE D
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-477-7272
Mailing Address - Fax:732-477-1182
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:BUILDING 2 SUITE D
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-477-7272
Practice Address - Fax:732-477-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102582900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty