Provider Demographics
NPI:1396951505
Name:GULATI, AJAY (BDS MS)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:
Last Name:GULATI
Suffix:
Gender:M
Credentials:BDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 W RALPH M HALL PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6655
Mailing Address - Country:US
Mailing Address - Phone:469-698-8282
Mailing Address - Fax:972-771-8638
Practice Address - Street 1:1010 W RALPH M HALL PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6655
Practice Address - Country:US
Practice Address - Phone:469-698-8282
Practice Address - Fax:972-771-8638
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics