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General NPI Number Information
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NPI Number | 1538313366
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Entity Type | Organization
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Legal Business Name | GULICK & GULICK D.D.S., P.C.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 1103 S CEDAR ST SUITE 100
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City | MASON
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State | MI
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Zip | 48854-2081
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Country | US
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Telephone | 517-676-5900
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Fax | 517-676-5877
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Provider Business Mailing Address
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Address Line | 1103 S CEDAR ST SUITE 100
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City | MASON
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State | MI
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Zip | 48854-2081
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Country | US
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Telephone | 517-676-5900
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Fax | 517-676-5877
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DANIEL C GULICK
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Credential | D.D.S.
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Telephone | 517-676-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12797
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12796
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License Number State | MI
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