Healthcare Provider Details

I. General information

NPI: 1356363717
Provider Name (Legal Business Name): WILLIAM D. SULIK D.D,S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MARTIN LUTHER KING JR BLVD
CHAPEL HILL NC
27514-2619
US

IV. Provider business mailing address

920 MARTIN LUTHER KING JR BLVD
CHAPEL HILL NC
27514-2619
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-0220
  • Fax: 919-968-8767
Mailing address:
  • Phone: 919-968-0220
  • Fax: 919-968-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberNC 4452
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: