Provider Demographics
NPI:1447292040
Name:HULSHULT, EUGENE STANLEY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:STANLEY
Last Name:HULSHULT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COPPER BEECH RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3667
Practice Address - Country:US
Practice Address - Phone:603-228-0123
Practice Address - Fax:603-228-0124
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice