Provider Demographics
NPI:1366407017
Name:HUPALO, DALE M (DMD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:M
Last Name:HUPALO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 OLD RODGERS RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-1723
Mailing Address - Country:US
Mailing Address - Phone:215-945-5199
Mailing Address - Fax:215-945-6290
Practice Address - Street 1:7419 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1008
Practice Address - Country:US
Practice Address - Phone:215-945-5199
Practice Address - Fax:215-945-6290
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020303L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist