Provider Demographics
NPI:1821514159
Name:DUL, DAREK (DMD)
Entity Type:Individual
Prefix:
First Name:DAREK
Middle Name:
Last Name:DUL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 NW 27TH AVE STE E-12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4909
Mailing Address - Country:US
Mailing Address - Phone:786-318-2337
Mailing Address - Fax:786-513-8217
Practice Address - Street 1:7900 NW 27TH AVE STE D
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:786-318-2337
Practice Address - Fax:786-513-8217
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist