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NPI Code Detail

MEDICARE: JULIAN GAPUD D.D.S.

MEDICARE: JULIAN GAPUD D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry8831SC
2390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1710370663
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIAN GAPUD D.D.S.
Provider Business Mailing Address
First Line : 1825 S LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-7759
Country : US
Telephone Number : 843-327-3175
Fax Number :
Provider Business Practice Location Address
First Line : 1825 S LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-7759
Country : US
Telephone Number : 843-327-3175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2015
Last Update Date : 09/12/2016

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