Provider Demographics
NPI:1609449826
Name:PALSULE, RUJUTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUJUTA
Middle Name:
Last Name:PALSULE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 FOLSOM ST APT 557
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2174
Mailing Address - Country:US
Mailing Address - Phone:404-226-1208
Mailing Address - Fax:
Practice Address - Street 1:907 BUFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-2711
Practice Address - Country:US
Practice Address - Phone:678-922-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-24
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106448122300000X
GADN122401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist