Provider Demographics
NPI:1225189681
Name:LALWANI, GUL (DMD)
Entity type:Individual
Prefix:DR
First Name:GUL
Middle Name:
Last Name:LALWANI
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 1:1 BRITTON PL
Mailing Address - Street 2:SUITE 14
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-772-1122
Mailing Address - Fax:856-772-0510
Practice Address - Street 1:1 BRITTON PL
Practice Address - Street 2:SUITE 14
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-772-1122
Practice Address - Fax:856-772-0510
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222128576OtherFEDERAL ID NUMBER