Individual
IRENE GULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
61 W 144TH ST, RIVERDALE, IL 60827-2850
(708) 849-8627
Mailing address
1642 N LARRABEE ST, CHICAGO, IL 60614-5620
(312) 933-6555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019025314
IL
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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