Provider Demographics
NPI:1427274125
Name:GULLAND, CHARLES EARL (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EARL
Last Name:GULLAND
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 1:490 N KERRWOOD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5202
Mailing Address - Country:US
Mailing Address - Phone:724-981-3950
Mailing Address - Fax:724-981-9890
Practice Address - Street 1:490 N KERRWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5202
Practice Address - Country:US
Practice Address - Phone:724-981-3950
Practice Address - Fax:724-981-9890
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-027133-L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics