Provider Demographics
NPI:1669640199
Name:GUL R. LALWANI D.M.D. P.A.
Entity Type:Organization
Organization Name:GUL R. LALWANI D.M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:LALWANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-772-1122
Mailing Address - Street 1:1 BRITTON PL
Mailing Address - Street 2:SUITE 14
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-772-1122
Mailing Address - Fax:856-772-0510
Practice Address - Street 1:1 BRITTON PL
Practice Address - Street 2:SUITE 14
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-772-1122
Practice Address - Fax:856-772-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008656001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty