Provider Demographics
NPI:1770753147
Name:GULINO, THOMAS JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:GULINO
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 1:727 RARITAN RD
Mailing Address - Street 2:SUITE 202 B
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2229
Mailing Address - Country:US
Mailing Address - Phone:732-574-0300
Mailing Address - Fax:732-574-9871
Practice Address - Street 1:727 RARITAN RD
Practice Address - Street 2:SUITE 202 B
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2229
Practice Address - Country:US
Practice Address - Phone:732-574-0300
Practice Address - Fax:732-574-9871
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-02
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017605001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice