Provider Demographics
NPI:1841603313
Name:HULGAN, COTY (DMD)
Entity Type:Individual
Prefix:DR
First Name:COTY
Middle Name:
Last Name:HULGAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:COTY
Other - Middle Name:
Other - Last Name:CANTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:427 S 4TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5282
Mailing Address - Country:US
Mailing Address - Phone:256-467-3638
Mailing Address - Fax:
Practice Address - Street 1:427 S 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5282
Practice Address - Country:US
Practice Address - Phone:256-467-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6124122300000X, 1223P0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program