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General NPI Number Information
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NPI Number | 1437729365
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Entity Type | Individual
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Provider Name | THOMAS ULICNY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 2299 BRODHEAD RD STE F
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City | BETHLEHEM
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State | PA
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Zip | 18020-8990
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Country | US
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Telephone | 610-882-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 28 CURTIS PL
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City | LYNBROOK
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State | NY
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Zip | 11563-2010
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Country | US
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Telephone | 516-418-7905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22DI02724600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 063021
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS043312
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License Number State | PA
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