Provider Demographics
NPI:1689864498
Name:GILDON, JULIA TULLOS (DDS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:TULLOS
Last Name:GILDON
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 1:5 VAN CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-5211
Mailing Address - Country:US
Mailing Address - Phone:501-664-5615
Mailing Address - Fax:501-664-9118
Practice Address - Street 1:5 VAN CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5211
Practice Address - Country:US
Practice Address - Phone:501-664-5615
Practice Address - Fax:501-664-9118
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist