Provider Demographics
NPI:1538783287
Name:USUL, TUGRABERK (DMD)
Entity type:Individual
Prefix:DR
First Name:TUGRABERK
Middle Name:
Last Name:USUL
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 1:130 SIMPSON RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9625
Mailing Address - Country:US
Mailing Address - Phone:302-423-6676
Mailing Address - Fax:
Practice Address - Street 1:1070 OLD NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:PA
Practice Address - Zip Code:15333-2114
Practice Address - Country:US
Practice Address - Phone:724-632-6801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0426771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice