Provider Demographics
NPI:1285914176
Name:HULL, ERIC D (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:D
Last Name:HULL
Suffix:
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 1:1905 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-2181
Mailing Address - Country:US
Mailing Address - Phone:989-430-8088
Mailing Address - Fax:
Practice Address - Street 1:769 YORK CREEK DR NW
Practice Address - Street 2:
Practice Address - City:COMSTOCK PARK
Practice Address - State:MI
Practice Address - Zip Code:49321-8712
Practice Address - Country:US
Practice Address - Phone:616-784-2377
Practice Address - Fax:616-784-0707
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist