Provider Demographics
NPI:1053406587
Name:HULL, STEPHEN EDWARD (DMD, PC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:HULL
Suffix:
Gender:M
Credentials:DMD, PC
Other - Prefix:
Other - First Name:S.
Other - Middle Name:E
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD, PC
Mailing Address - Street 1:2400 WILLAMETTE STREET
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-485-0272
Mailing Address - Fax:541-485-0139
Practice Address - Street 1:2400 WILLAMETTE STREET
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-485-0272
Practice Address - Fax:541-485-0139
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD49451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice