Individual
DIVYA GULATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
322 S 6TH AVE, WAUCHULA, FL 33873-3207
(863) 773-9344
Mailing address
322 S 6TH AVE, WAUCHULA, FL 33873-3207
(863) 773-9344
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.030035
IL
122300000X
Dentist
Primary
31015
TX
1223G0001X
General Practice Dentistry
DN26793
FL
Other
Enumeration date
09/03/2014
Last updated
07/06/2022
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