Provider Demographics
NPI:1265435259
Name:TULMAN, JEFFREY M (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:TULMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 BROADHOLLOW RD
Mailing Address - Street 2:STE 102
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4701
Mailing Address - Country:US
Mailing Address - Phone:631-752-1033
Mailing Address - Fax:631-752-1034
Practice Address - Street 1:425 BROADHOLLOW RD
Practice Address - Street 2:STE 102
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4701
Practice Address - Country:US
Practice Address - Phone:631-752-1033
Practice Address - Fax:631-752-1034
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
NY0366041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery