Gullikson, Gregory Lee

Gullikson, Gregory Lee is an individual health care provider with primary practice located at 1853 Knox Mcrae Dr , Titusville FL 32780-5492. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gullikson, Gregory Lee can be contacted via phone (321) 267-2934.

Contact Information

Primary practice address
1853 Knox Mcrae Dr Titusville FL 32780-5492
Phone: (321) 267-2934
Fax: (321) 267-3698
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN0011987 Florida

Profile Details

NPI number 1851405732
LBN Legal business name Gullikson, Gregory Lee
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851405732 NPPES
Florida Other 63699 BCBS PROVIDER NUMBER

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