Provider Demographics
NPI:1982653853
Name:GULU, GEORGE JAMES SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JAMES
Last Name:GULU
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6563 DEESIDE DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9457
Mailing Address - Country:US
Mailing Address - Phone:614-761-2968
Mailing Address - Fax:
Practice Address - Street 1:2079 EAKIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3294
Practice Address - Country:US
Practice Address - Phone:614-274-8500
Practice Address - Fax:614-274-9687
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17790122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist