Provider Demographics
NPI:1881666832
Name:HULL, GEORGE RICHARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RICHARD
Last Name:HULL
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 1:7801 AMETHYST DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-8381
Mailing Address - Country:US
Mailing Address - Phone:850-453-9811
Mailing Address - Fax:
Practice Address - Street 1:450 TURNER ST
Practice Address - Street 2:SUITE A
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-5211
Practice Address - Country:US
Practice Address - Phone:850-452-5600
Practice Address - Fax:850-452-8173
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026133L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice